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AN  ENGLISH  TRANSLATION 

OF 

THE  SUSHRUTA  SAMHITA 

WITH 


A  FULL  AND   COMPREHENSIVE   INTRODUCTION,  ADDITIONAL  TEXTS, 

DIFFERENT   READINGS,    NOTES,   COMPARATIVE   VIEWS, 

INDEX,   GLOSSARY   AND   PLATES 


IN  THREE  VOLUMES 


EDITED    BY 

KAVIRAJ  KUNJALAL  BHISHAGRATNA,  m.r.a.s. 

Vol.   II. 

NIDANA-STIIANA,  S'ARIRA-STMANA,  CIIIKITv^ITA- 
^    .STIIANA  AND  KALArA-STIIANA. 


CALCUTTA: 
PUBLISHED  BY  THE  AUTHOR, 

NO.  10,   KASHI   GROSE'S   LANE 

I9II  * 

AH  Rights  Reserved, 


PRINTED  BY  M.   BHATTACHARYYA,   AT  THE  BHARAT    MIHIR  PRESS, 
25,  ROY  BAG  AN  STREET,  CALCUTTA. 


MAY  3  0  ?oni 


PREFACE. 


It    is    with    mingled    feelings    of    pain    and 
pleasure  that  we  now  place  before  the  public    the 
Second    Volume    of  our  English    Translation  of 
the  Susruta  Samhita.    The  arduous  task  of  com- 
piling  a   connected   and  succint  history    of   any 
part    whatever,    of    the    ancient    Hindu    System 
of  Medicine — requires   greater   leisure  and   more 
extensive   reading   than    we    can    lay   any    pre- 
tension to.     Years  of  patient  study  and    constant 
discourse   with   our    sainted    preceptor   the    late 
lamented    Mahamahopadhyaya  Kaviraj  Dwaraka 
Nath    Sen,    Kaviratna,    that  refulgent  link  of  the 
golden'' .  chain    of    the    Dhanvan^aric   succession, 
have  enabled  us,  however,  to   grasp    the    leading 
facts,    and   during'  thje.Iast   few    years    we  have 
worked  contihutrusly^^n-moments   snatched    from 
the    practice  of  an  anxious  profession  that  knows 
no  respite,  to  arrange  these  facts  in  their  present 
form.     It   breaks    our   heart   to   record    the  sad 
departure  of  our  venerable    Acharyya   from    this 
sublunary  sphere   to  a  land  'from  whose  bourne 
no   traveller  e'er  returns.'* 

It  is  hardly  necessary  for  us  to  reply  to  those 
critics  who,  through  their  ignorance  of  the  original 


L^e.^^ 


(      2       ) 

Sanskrit  works,  persist  in  describing  Ayurveda 
as  an  empirical  system  destitute  of  Anatomy, 
Physiology  or  Pathology  in  any  scientific  sense. 

It  behoves  us,  however,  in  this  preface  to  meet 
some  of  the  charges  which  have  been  brought 
against  us. 

Exception  has  been  taken  to  our  not  includ- 
ing in  the  opening  stanza  the  usual  invocation 
to  the  Supreme  Self  (for  a  successful  completion 
of  the  work)  although  it  has  found  its  way  into 
almost  all  the  printed  editions  of  the  work  extant. 

Now  the  stanza  referred  to  finds  no  place  in 
the  various  manuscript  copies  of  the  original 
work  which  are  in  our  possession,  or  on  which 
we  have  been  able  to  lay  our  hands.  The  work 
was  first  put  into  print  by  the  late  Dr.  Madhu- 
sudan  Gupta  and  we  believe  that  it  was  only 
in  this  printed  edition  that  the  benedictory 
address  in  question  appeared  for  the  first  time, 
and  that  it  has  since  crept,  by  the  process  of 
circulation,  into  subsequent  printed  editions. 

In  this  opinion  we  are  supported  by  the  fact, 
that  in  none  of  the  various  commentaries  and  anno- 
tations on  the  Susruta  Samhita  is  any  mention 
made  of  the  line  in  question,  whereas,  had  it  been 
the  opening  stanza  of  the  original  work,  it  would 
certainly  have  received  at  least  a  passing  notice 
at  the  hands  of  the  commentators,  however  easy 
or  simple  it  might  have  been.  Further,  were  it 
composed   by  Susruta  himself,  it  would  not  have 


(     3     ) 

been  in  the  form  in  which  we  find  it  in  the  printed 
editions.  The  ancient  sages  used  invariably 
the  auspicious  expression  "^^Tci:'^  or  "^r^^'' 
and  the  like,  when  commencing  a  work  and 
never  invoked  any  particular  deity  for  a  happy 
termination  of  their  undertaking."^  These  are 
the  reasons  which  have  led  us  to  omit  the 
passage  in  our  present  translation. 

Another  objection  raised  by  a  certain  section 
of  the  community  is  that  we  should  not  have  at 
all  undertaken  to  translate  the  work  into  the 
English  language.  Their  contention  is  that  the 
Ayurveda,  being  an  integral  portion  of  the 
Eternal  Vedas,  should,  on  no  account,  be 
rendered  into  a  Mlechchha  Bhdshd  and  thus  made 
accessible  to  the  public  at  large,  irrespective 
of  caste  or  creed. 

Such  an  objection,  at  this  time  of  the  day,  is, 
to  say  the  least,  most  puerile !  Truth  is  truth,  and 
latitudes  and  longitudes  are  not  its  boundary 
lines.  The  Vedas  themselves  have  been  trans- 
lated into  many  European  languages.  To  keep 
the  truths  promulgated  by  our  ancient  sages  con- 
fined within  the  coterie  of  the  privileged  classes 
and   thus    to  deprive   the  educated  public  of  the 


*  Thus  :  — 

'a)     "^ram'f  fi^^^f^ffl^T'^z^Ts  asTTUmr^:"— Charaka  Samhita. 
(/;)     *'^^T^  >^'W  ^Ti^Mm:" — Kanada  Vaiseshika  Sutra 
(^)     "^^T^  ^^fsr^T^T"— Vedanta  Sutra. 


(     4     ) 

benefit  of  such  truths  would  certainly  be  a 
sacrilege.  In  giving  preference  to  English  as 
the  medium  of  translation  we  have  been  actuated 
by  more  reasons  than  one. 

It  cannot  be  gainsaid  that  English  has  now 
become  almost  the  lingua  franca  of  the  world, 
and  to  disseminate  the  ancient  wisdom  of  India 
throughout  the  world,  we  could  not  have  selected 
a  medium  better  than  the  English  language. 

Besides  this,  we  have  been  actuated  by  the 
hope  of  drawing  the  direct  attention  of  our  be- 
nign Government  to  the  scientific  value  of  our 
system  of  Medicine  by  the  adoption  of  such  a 
procedure. 

Here  we  must  not  stop  without  expressing 
our  sincere  and  hearty  thanks  to  our  learned  and 
valued  friends  Kaviraj  Jogindranath  Sen,  M.A., 
Vidyabhusana,  Kaviraj  Jnanendranath  Sen,  B.A., 
Kaviratna  and  Professor  Satyendranath  Sen, 
M.  A.,  Vidyavagisa,  who  have  rendered  us  material 
help  in  the  publication  of  this  volume.  We  must 
freely  admit  that  but  for  the  active  and  continued 
co-operation  of  the  above-named  gentlemen  we 
could  not  have  brought  out  this  volume  so 
promptly  and  successfully.  Our  thanks  are  also 
due  to  Dr.  S.  Sanyal,  B.Sc,  L.M.S.  for  his  kind 
help,  to  Dr.  S.  N.  Goswami,  B.A.,  L.M.S.  for 
his  kindly  supplying  us  with  materials  for  writing 
the  Introduction,  and  to  our  readers  for  their 
kind  encouragement 


(     5    ) 

In  conclusion,  we  implore  our  readers  to 
excuse  the  errors  of  omission  and  commission 
which  are  inevitable  in  the  execution  of  such  a 
huge  work,  more  especially  when  the  author  is 
encumbered  with  the  responsible  duties  of  his 
profession  involving,  as  they  do,  the  life  and 
death  of  persons  entrusted  to  his  care. 


10,  KASHI  GHOSHE'S  LANE,^ 

Calcutta.  I  KuNJA  LaL  BhISHAGRATNA. 

November^  igii,  ' 


INTRODUCTION. 


In  the  introduction  of  the  first  volume  of  our  translation 

of  the  Susruta-Samhita  we  have  attempt- 

Ayurveda  is  not  ed  to  place  before  the  public  a  correct 
an      Encyclopaedia  .,^,        _,.  ,  „     . 

of  ancient  medical      interpretation  of  Vayu,  Pitta  and  Kapha, 

Mse  on  Biology!''^^^'  ^^^  ^^^^^^^  so-called  humours  of  the 
body*  and  it  is  a  great  pleasure  to  us, 
that  our  pronouncement  has  been  very  kindly  accepted.  In 
the  introduction  of  the  present  volume  we  would  draw  the 
attention  of  the  readers  to  the  fact  that  Ayurveda  is  not  at 
all  an  encyclopaedic  work, — an  Encyclopaedia   of  the   Indian 

*  Berdoe  says  :— "What  is  known  as  the  Humoral  Pathology  formed 
the  most  essential  part  of  the  system  of  the  Dogmatics.  Humoral 
Pathology  explains  all  diseases  as  caused  by  the  mixture  of  the  four 
cardinal  humours,  viz.,  the  blood,  bile,  mucus  or  phlegm  and  water.  Hip- 
pocrates first  leaned  towards  it,  but  it  was  Plato  who  devoloped  it.  The 
stomach  is  the  common  source  of  all  these  humours.  When  diseases 
develop,  they  attract  humours.  The  source  of  the  bile  is  the  liver,  of  the 
mufcus  the  head,  of  the  water  the  spleen.  Bile  causes  catarrhs  and  rheu- 
matism, dropsy  depends  on  the  spleen." 

Be  it  observed  that  among  the  humours  of  Hippocrates  there  is  no 
place  for  Vata  although  in  point  of  fact  both  his  Physiology  and  Patho- 
logy are  to  be  traced  to  the  "Tri-dhatu"  of  Ayurveda.  The  secret  of 
this  anomaly  is  that  the  theory  of  Vata  was  found  to  be  a  complicated  one 
and  Hipprocates,  not  being  able  to  comprehend  its  original  import,  left 
it  out  and  cautiously  introduced,  in  its  stead,  his  own  theory  of  "water". 
Sowe  find  "Humoral  Pathology  is  not  of  Indian  origin  ;  neither  it  is  the 
same  which  the  Indian  Rishis  of  Rigveda  developed  under  the  name  of 
Tri-dhatu."  It  is  simply  an  imitation  of  Susruta  who  introduced  blood 
(  ^[<!)ci-M<j^'i  )  ^s  the  fourth  factor  in  the  genesis  of  diseases.  Bui  the  bor- 
rower, in  his  interpretation  of  Susruta,  had  made  a  mess  of  it.  He  retain- 
ed blood,  but  substituted  "water"  in  place  of  Vkta,  the  most  important 
of  the  three,  for  reasons  best  known  to  him. 


il  INTRODUCTION. 

system  of    Medicine   in    all   its   departments,   but  it  is  the 
Science  of  Life  entire. 

Though  it  is  customary  and  convenient  to  group  apart 
such  phenomena  as  are  termed  mental  and  such  of  them  as 
are  exhibited  by  men  in  society,  under  the  heads  of  Psycho- 
logy and  Sociology,  yet  it  must  be  allowed  that  there  are  no 
absolute  demarcations  in  Nature,  corresponding  to  them, 
and  so  in  the  entire  Science  of  Life,  psychology  and  sociology 
are  inseparably  linked  with  Anatomy  and  Physiology,  nay, 
more,  with  Pathology  and  Hygiene  and  above  all  with 
Treatment.  In  short  the  Biological  Sciences  must  deal  with 
whatever  phenomena  are  manifested  by  living  matter  in 
whatever  condition  it  is  placed.  Life  in  health  (  ^^5:  )  as 
well  as  Life  in  disease  (  ^:?irTf:  ),  therefore,  fall  within  the 
scope  of  Biology— even  life  exhibited  by  man  in  Society 
(  f%cTTf%cf )  is  not  exempted  from  it. 

f^cnficf  ^Ji  -^'MM^i^^f  f%mf%cT^  1 

^^^  era  ^5r^?TT#V.  ^  ^'^  11  '^T^,  #^r^T,  x^  ^'^m  1 

In   calling  Ayurveda,  therefore,  the  entire  Science  of  Life, 

Ayurveda, the     "^^   ^'^   "°^  ^"'^^^   ^^    ^"^   prejudice 

entire    Science    of     of    our    own,    but   we   rely   solely   on 

^  ®*  facts   and   figures,     and     these,     when 

closely  studied,    will   lead   any   one    to   arrive  at   the    same 

conclusion,   not   unlike   our   own  and  to  interpret   Ayurveda 

as   a   collection   of  Biological   Sciences   in    all   departments. 

Ill    the   firs':   place,    for   the  guidance  of  our  readers,  we  will 

mention  that  the   name    Ayurveda   itself  is  a  strong  evidence 

in  favour  of  its  being  called  the  Science 
Negative  Eviden-      ^r  t  -^^      o        ji  n       c 

ces  thereof:—  Of  Life.     Secondly,    we   will   refer  to 

I.  The  Name  it-      (\^q  arrangement   of  the  subject-matter 

in     the    Sarira-sthana   which  is   popu- 
larly  belived  to  be   the  anatomical    portion    of  the   book,  as 

tending    to   the    same  conclusion.     In 

II.  The  arrange-       ..  .  .      .  ....   ., 

ment    of   the  sub-     this     section,   chapters   on     Midwifery 

ject-matters.  ^nd    Management     of    Infants     follow 

close  to  the  heels  of  those    on  Anatomy  and  Physiology,  and 


INTRODUCTION.  iH 

these  latter  again  are  immediately  preceded  by  chapters 
on  Psychology.  This  intermixture  is  certainly  an  anomaly 
and  can  in  no  wise  be  satisfactorily  explained  unless  we 
have  to  look  upon  these  as  general  truths  of  Biology, 
elucidated  by  the  Introduction  of  special  truths  exclu- 
sively collected  from  the  science  of  medicine — fviw^rrf^^  ^^T^ 
4j»<[Mlciif*f  I  To.  call  it  Descriptive  Anatomy  or  Physiology, 
in  the  modern  sense  of  the  term  is  simply  ridiculous.  The 
absence  of  any  reference   to   brain    and 

Want  of  Descrip-      spinal  cord,  to  pancreas   and   heart,   in 
tive  Anatomy  and       ^  >       f  » 

Physiology  in   the      a   book   of  Anatomy  and  Physiology  is 

Ithlnaitself^-^"^^"      unpardonable  and  in  the  Sarira-sthana 
we   feel   this  absence  almost  to  despon- 
dency.    Moreover,   in    western    medical  science,  Grey's  Ana- 
tony   and   Kirke's    Physiology,    for   instance,  in    their    bulk, 
exceeds,  each,  more  than  a  thousand  of  pages  and  to  present 
to   the   public,   under   the  same   name  less  than  half  a  dozen 
of  pages,  as   the  result  of   Indian  wisdom,  is  certainly  a  very 
miserable   contrast — a  contrast  that    is   calculated    to  inspire 
no  admiration,  but,  on  the  contrary,  to   generate  in  scientific 
minds  an  universal  apathy,  at  least  an  apathy  towards  all  that 
is  connected   with  the  system  of  Indian  Medicine.     In  order 
to  save  our  venerable   Rishis  from    this  disastrous  plight,  we 
announce   here   foremost   of  all,   that   our    beloved  Science 
of  Ayurveda  is    by   no   means  an    Encyclopaedic   work,    but 
distinctly  possesses  every   characteristic 
ces°^'*'''®  ■^'''^®''"      that   "^a^^s    the    Science   of     Biology. 
I    The  definition     The     very   name     Ayurvada   indicates 
Same  as  Life  as      that    it   is   actually   a   science  of   Ayus 

same    sense    as   Mr.    Herbert   Spencer 
understands  by  his  remarkable  definition  of  Life. 

In  liis  masterly  classification  Mr.  Herbert  Spencer  has, 
in  his  Biology,  given,  indeed,  the  first  place  to  Anatomy  and 
Physiology,  but  still  it  is  divested  of  any  elaborate  chapters 
dealing  with  the  subjects. 

B 


IV  INTRODUCTION. 

In  the  science  of  Life  a  short  reference  to  the  structures 
of  the  body  or  its  functions  is  quite  sufficient  to  illustrate 
its  principles,  and  if  we  fail  to  find  therein  any  discourse  on 
the  descriptive  Anatomy  and  Physiology,  we  still  consider 
that  there  is  nothing  amiss. 

But  unfortunately  the  fate  of  Ayurveda  is  otherwise. 
Though  the  very  name  indicates  that  it  is  Biology  pure  and 
simple,  still  it  is  denounced  for  its  dificiencies  in  Anatomy 
and  Physiology,  and  doomed  for  ever. 

Sanskrit  words  are  notorious  for  their  confusion  of 
meanings,  but,  as  regards  Ayurveda  there  exists  no  difference 
of  opinion,  at  least,  so  far  as  the  first  word  is  concerned. 
Ayus  is  Ayus  everywhere  in  Ayurveda  and  it  is  the  only  fault 
our  venerable  Rishis  may  be  reasonably  charged  with,  that 
they  did  not  put  themselves  into  any  great  trouble  to 
explain  Ayus,  but,  on  the  contrary,  unlike  scientific  men, 
misspent  their  energy  to  ascertain  the  significance  of  the 
insignificant  portion  of  Ayurveda,  that  is  the  meanings  of  the 
root  "F/^a"  in  the  light  of  Grammar. 

The  scientific  ear,  ever  unsatisfied  with  these  grammati- 
cal eruditions,  has  ultimately  thrust  an  Encyclopaedic  value 
upon  what  is  properly  speaking,  a  book  of  Biology.  Of  course, 
there  is  a  marked  difference  between  the  two.  An  ordinary 
treatise  on  Biology  deals  with  the  general  truths  of  life, 
and  does  not  represent,  by  way  of  illustrations,  all  its  special 
truths,  nor  their  practical  sides,  but  so  far  as  Ayurveda  is 
concerned,  the  general  truths  of  Biology  are  thrown  into  the 
background  and  the  special  truths,  gleaned  exclusively  from 
the  science  of  medicine,  are  given  great  prominence  (fir^^irf^ 
^T^  ^^^f^cnf'T ),  so  much  so,  that  it  is  now  regarded 
as  a  system  of  Medicine  and  Surgery  which  has  neither 
Biology,  nor  Anatomy,  nor  Physiology,  nor  Pathology — but 
is  a  systematised  Empiricism  or  Quackery.  This  is  certainly 
a  great  misfortune.  Apart  from  the  name,  the  arrangement 
of  the  subject,  to  which  we  have  just  referred,  at  least,  in 
the   section  of  Sarira-sthana  (the  falsely  so-called  Anatomy  of 


INTRODUCTION.  V 

the  Hindus), — is  a  direct  contradiction  to  its  bieng  considered 

as  an  Encyclopaedic  work.     The  existence  of  the  chapters  on 

midwifery  and  management  of  infants  in  the  same,  following 

immediately  the  chapters   on    Anatomy,  serves   as   a    strong 

additional   evidence    thereof.     It  is   an    anomaly  no   doubt, 

that  Midwifery  has  been    offered   a   place  in    the   section    of 

Anatomy,  but  the  confusion   does   not 
Reasons  for  in  cor-         .    .    ,,         t       j  j     -r  i  j. 

porating  Midwifery     get  at  all  confounded,    if  we  are  led  to 

into  this  Anatomi-      believe    that    the  science  of  generation 
cal  section.  ^ 

of    a   superior   race   (if  we   are  at   all 

permitted  to  use  the  term)  forms,  indeed,  an  important  depart- 
ment of  Practical  Biology. 

From  whatever  standpoint  we  look  to  the  question,  we 
find  there  are  grounds  to  lead  any  one  to  pronounce  in 
our  favour  and  to  come  to  the  conclusion  at  which  we 
now  venture  to  arrive.     Besides  these   two   important   facts, 

we    now   cite   the  following  passage  as 

Internal  evidence.  ^         •  .        i        j         •    r  c 

a  strong  mternal  evidence  in  favour   of 

our  view.     Maharshi  Punarvasu,  after  giving  us  a  short  table 

of  the   principal   structures  of  the  human  body,  remarks  that 

even    this   reference  is  considered   by    many  as  superfluous, 

Reasons  for  omit-      ''^   '^^   S'°"°^'   ^^^^  ^"  acquaintance 
ting      Descriptive      with  the  molecular   construction    of  an 

organism   is   quite   sufficient  to  help  us 

as  a  reliable  guide  to  treatment. 

The  passage  referred  to  is  quoted  below  : — ■ 

Now  we  ask  the  reader  if  this  is  not  a  sufficient  evidence, 
proving  to  the  hilt,  that  Ayurveda  is  nothing  but  Biology 
and  that  we  run  no  risk  of  committing  a  grave  omission  if 
the  chapter  on  Anatomy  is  wholesale  dispensed  with  from 
Ayurveda.  For  the  improvement  of  this  awkward  position — 
that  in  the  section  of  Anatomy  there  should  be  no  Anatomy 
^-Ihe  entire  credit  is  due  to  Susruta,  as  he  has  very  wisely 
made  the  suggestion,  that  a  knowledge  of  the  anatomical 
structures  of  the  body  is  of  great  value,  at  least  so   far    as   it 


VI  INTRODUCTION. 

helps  the  Surgeons  and  the  Surgeons  only  in  their  operations.* 
But  so  far  as  Biology  is  concerned  with  medicine,  Susruta 
does  not  forget  to  lay  particular  stress  on  the  knowledge  of 
the  molecular  construction  of  the  body.  The  following 
memorable  passages  actually  preached  by  this  renowned 
Surgeon,  some  three  hundred  centuries  ago,  still  stands  as  a 
model  from  which  modern  Science,  even  in  its  present  ad- 
vancement, can  draw  inspirations. 
He  says  : — 

I.      T  ^^^l^T  5^'  tf  \^cPH\  f%H*.  I 

^^cTT'^it  ^^'^'T^T^'giT'^^ff  fen:  II 

IT<5m^  f%  ^^  ?^  ^Ml^^  Wtrl  I 

^RRTcT^^^  ^  '5TTf%^Tii[  II 

That  is,  the   protean  work  of  the  protoplasm  in  which  the 

great  Self  resides  cannot  be  detected  by   the    body's  eye  ;   to 

know  its  work,  mind's  eye  is  necessary,  along  with  the  body's 

eye.    For  acquiring  efificiency  in  Surgery  alone,   the  dissection 

*  Susruta  recommends  dissection  on  dead  human  bodies  and  suggests 
that  it  is  only  required  of  those  who  will  practise  surgery  and  that  students 
of  medicine  can  do  without  it.  Herophilus  practised  dissection  on 
living  bodies  and  with  the  object  of  practising  medicine  successfully, 
but  it  soon  fell  into  disrepute  and  did  not  at  all  influence  the  art  of 
Medicine.!  He  was  condemmed  even  by  his  own  pupil  Philinus  of  cos 
who  declared  that  all  the  Anatomy  his  vivisecting  master  had  taught  him 
had  not  helped  him  in  the  least  in  the  cure  of  his  patients.  Such 
indeed  was  the  fate  of  vivisection  for  which  Europe  now  takes  pride. 

But  Susruta's,  Avagharskana  is  now  considered  by  many  as  the  only 
perfect  mode  of  dissection  ever  known.  It  is  with  the  help  of  this 
method  of  dissection  that  the  layers  of  epidermis  and  dermis  could  be 
discovered  and  blood-vessels  with  their  minute  branches  could  be  counted 
to  be  as  many  as  thirty  millions.  Not  only  this,  but  also  in  the  opinion  of 
several  European  savants,  Susruta  still  stands  as  a  model  of  surgery  and 
European  surgery  has  borrowed  many  things  from  Susruta  and  has  yet 
many  things  to  learn. 


INTRODUCTION.  Vll 

of  dead  body  (not  of  living  body  as  proclaimed  by 
Herophilus),  nay,   the  Avagharshana  which  brings    into  view 

The     knowledge  ^^^     ^^^^^^  °^  ^^^   epidermis   and    the 

of    the    Molecular  dermis,  the   number  and    branches    of 

Construction  of  the  .,      ,  ,         ,  ,       ,.         ,     -, 

body  is  all  that  is  blood-vessels  and  nerves  that  lie  embed- 

wanted.  ^^^  j^  muscles,  etc  ,  is  only   necessary. 

Professor  Michael  Foster's  remarks  in  his  article  on 
Physiology  in  the  Encyclopedia  Britannica,  to  all  appearnces, 
are  just  in  the  same  line,  if  not  identical  with  our  extract, 
when  he  says  **that  the  problem  of  Physiology,  in  the  future, 
is  largely  concerned  in  arriving  by  experiment  and  infer- 
ence, by  the  mind's  eye,  and  not  by  the  body's  eye  alone, 
assisted,  as  that  may  be,  by  lenses  yet  to  be  introduced 
at  a  knowledge  of  the  molecular  construction  of  the  protean 
protoplasm  ;  of  the  laws  according  to  which  it  is  built  up 
and  the  laws  according  to  which  it  breaks  down  ;  for  these 
laws  when  ascertained  will  clear  up  the  mysteries  of  the 
protean  work  which  the  protoplasm  does." 

Ijo  short  the  knowledge  of  the  molecular  construction  of 
the  body  is  just  the  thing  with  which  Biology  is  concerned, 
and  such  is  the  unanimous  verdict  both  in  the  East  as  well  as 
in  the  West,  in  the  most  ancient  and  in  the  most  modern 
Sciences  of  the  world.  Now,  if  the  'knowledge  of  the  molecular 
construction  of  the  protoplasm,  of  the  laws  according  to  which 
it  is  built  up,  and  the  laws  according  to  which  it  breaks  down,' 
is  all  that  is  necessary  for  an  accurate  knowledge  of  Anatomy 
and  Physiology,  our  Ayurveda  is  pre-eminently  the  Science 
we  want. 

The  following  extracts,  from  Charaka  Samhita,  are  cited 
here  to  prove  that  we  are  quite  justified  in  our  contention. 

2.    ^fl?:^icrTt  ^  %  ^%^^5mt  fir^^  1 

That  is,  the  body  is  composed  of  molecules  and  these  are 
said  to  be  numberless,  because   no  body  can  count  them   up. 


Vlll  INTRODUCTION. 

By  their  union,  they  build  up  the  body,  and  this  union  is 
governed  by  three  Laws,  viz.,  the  Laws  of  Vayu,  Karma  and 
Swabhava  (which  are  almost  equivalent  to  the  three  Biological 
Laws,  Z^.,  the  law  of  heredity,  the  law  of  external  relations  and 
the  law  of  molecular  motion  caused  by  Ethereal  vibrations 
compared  with  which  nerve-impulses — akin  to  electric  force, — 
are  grosser  and  coarser  shocks).  So  far  we  think  we  have 
proved  that  Ayurveda,  as  a  Biology  is  not  defective,  if  it 
contains  no  descriptive  Anatomy  and  Physiology— descriptive 
in  the  same  sense  as  Grey's  Anatomy  or  Kirke's  Physiology  is. 
Its  Histiology  is    molecular;     its  Pathology  is  molecular  ;    its 

Physiology  is  molecular.    Molecular  in  every  sense  is 

the  Biology  of  the  Hindus.  Virtually  speaking,  Ayurveda  is 
our  Science  of  Life,  and  we  will  presently  shew  that  Lije 
and  Ayus  are  identical. 

The  continuous  adjustment  of  molecules,  their  successive 
breaking  down  and  building  up  within  an  organised  living 
body,  without  destroying  its  identity,  is  the  definition  of  Ayus 
as  suggested  by  Maharshi  Punarvasu. 

He  says  :— 

In  another  place  the  same  definition  is  repeated  with  a 
slight    modification    and   in     this    he    enumerates  ^TTT^ff^:, 

(consciousness)  as  the  most   distinctive 
of'Ayu.    ^^^'^^^^^^     characteristic  of  ^I'wj.  According  to  this 

definition,  aifl^f^^r^imMT:  and  %i^Tg- 
?t^:  re'er  to  an  organised  living  body  ;  f^^:  and  '^ig^^:  are 
identical  with  processes  of  breaking  down  and  building  up  of 
the  organism  without  destroying  its  identity.  The  idea  of 
continuous  adjustment  is  included  also  in  these  two  words. 
So  we  find,  the  definition  oiAyus^  as  sugessted  by  Punarvasu, 

includes  more  than  what  is  proposed  in 

The  same  as  Life,      x/r     tt    u    ..  c  >  j  /-  •.•        t  t  -x 

Mr.  Herbert  Spencer's  definition  oi  Ltfe. 

The  words  ^ilr  and  eftf%?TiT,  as  explained  by  the  great  annotator 

Chakrapani,  represent  two  more  distinct  phases  of  Life,    the 


INRODUCTION.  IX 

first  bearing   upon    the   cistence    in    the  system  of  a  preven 

tivefactor  of  putrefaction,    the  second 

More        compre-  ...  ,    , 

hensive  than   Life      PO'»'"g    ^^    the    agent  or  agenr.     hat 

as  defined  by     Mr.      adjit    the  internal   relations 
Herbert  Spencer. 

catttouche?,  which    professor 

Foster  speaks  of  as  "contiuously  passing  from  protop 

protoplasm  and  compared/ith    which    the  nervous 

^    „         „.  ,      ,      (whih  are  perhaps  electrical  in 

Prof.         Michael     ^  , 

Foster  on  the  The-     are  rosser  and  coarser  shocks. ' 
ory  of  Sensation.  ^^-^^^^  ep'ahei,   viz.,   "^^lf^/'  as  em 

plained    by  Chakrapani — t^I^?^   mWT*[  ^TT^fw^'— furnishes  us\^ 
with  a  clue  to  determine  wat   Ayus   (  ^[^:  )   actually  means. 
Our  Sacred  Upanishads  now  come  for- 

J  Upa^n'fste   °^     ""-^^  °"'  '^"«f  ='"d  '«"  "'■  '"  'he  first 
place  "^g:  flTC"  ie ,    Ayu  and  Prana 
are  one  and  the  same  prinole.    In  the  second  place,  "?[:  im: 
^  ^:",  i.e ,  Prana  and  Vdy  are  identical.  In  the  third  place, 
'%  1^  ^^?i  ^fTT^n^'n'RT:",?'.^.,    Vayu   is    not    unlike    Ether. 
In  the  fourth  place,  '^T3  ^-^^t  w",    i.e,^    the  primitive  fluid 
^according  to  Lord  Kelvin)^  divided  into  two  parts,  viz.,  — 
without  motion,  another    edued  with  motion.     In  the 
place,     "^4f%«5in^if\     />.,  everything     in    this     world 
waves  of  this  Ether  enduecwith  motion.    In  the  sixth  pi 
"^rg^  ^*^:"  "^gx^  t%,  W  m^g",  ie.,  Vayu  is  the  univei-.^. 
store  of  energy ;   in  the  Phjical  world  it   is   known    by   the 
name  of  Vayu  ;    in    the    Liing  world    it  is  called    under   a 
different  name  and  that  nam  is  Prana  (mw.) 

From  the  above  short  tab  we  come  to  know  that  the 
agent  that  adjusts  the  internl  relations  to  external  relations, 
is  Ayus  and  that  Ayus  is  Liftand  that  Life  is  a  motion  of  the 
great  etherial  fluid  which  is  kown  in  Sanskrit  as  ^'is"  and  that 

*'^T^^  is  the    sum  of  all   the  various 
The  same  as  pri-  .      .  •  ,     •    ,        j     .  •  i     •    , 

mitive  fluid  as  de-      energie— biological   and   abiological— 

fined       by      Lord      which  nder  the  name   of  heat,   light, 

Kelvin.  »      5    I 

electricy  or  consciousness,  etc.,  manifest 

themselves  both  in  the  Physiil  as  well  as  in  the  Metaphysical 


^ 


X  INTRODUCTION. 

world,  and  that  Prana  (vm',)  is  another  name  of  the  same  force 
that,  in  acting  on  an  aggregated  living  body,  divides  itself 
into  five  distinct  forces,  viz.y  Prdna,  Apdna^  Samdna,  Uddna^ 
and  Vydna,  and  subserves  the  functions  of  correlation  (  ^rgt  ) 
and  sustentation  ( f^ )  and  controls  oxidation  (^^).  So 
Prana  continuously  helps  to  adjust,  like  the  main-spring  of  a 
watch,  the  internal  relations  to  the  external  relations.  We  are 
indebted  to  the  master  mind  of  Sankara  for  his  able  exposi- 
tion of  the  functions  of  this  main-spring, 
vJyu  a5dlth7r.  "^  ^^at  is,  of  the  etherial  vibrations  (mgiiro:) 
as  transformed  into  the  vital  force  in 
an  organised  body.  We  quote  below  what  he  says  about  it 
in  his  celeberated  commentary  on  the  Vedanta  Darsana. 

The  five  divisions                  -s  _-.  _c 

of  V^yu  in  its  ac-  'H^*   ^^  ^^"^  ^'^  '^  cf^T^^  STTST^  ^f- 

tion    on    a   living  ^^^  ,     ^fc^^w  ^  w^w^  ^  ^  fw-^  I 
aggregate. 

That  is,  the  primitive  fluid  that  is  endued  with  motion  in  its 
evolution  of  Life  gets  knotted  into  five  divisions,  viz ,  Prdna, 
Apdna,  Samdna,  Uddna  and  Vydna,  and  this  acting  on  any 
aggregated  living  matter  is  called  Prana.  So  what  we  call 
Prana  is  not  the  Vayu  itself,  but  a  particular  mode  of  its 
motion.  Hence  the  question  of  identity  and  non-identity  is  a 
matter  of  choice.  Shortly  speaking,  this  is  the  Biology  of 
the  Hindus.  This  too  is  the  sum  and  substance  into  which 
(as  a  department  of  Biology),  Physiology  unfolds  itself. 
This  too  evidently  serves  as  the  line  of 
Biology  forms  the  demarcation  between  ^TfT^:  and  ^'.^j:, 
^^fl'n^T^evllopel  f^:  -^  ^fwj.  From  this  too 
as  so  much  col-  Health  and  Disease,  Hygiene  and 
lateral  branches.  r^,^^^^^^^^    Psychology  and  Sociology 

have  all  their  origin  and  start.  In  fact.  Biology  forms  the  basis 

upon  which  the  great  edifice  of  the  Indian  Medical  Science,  as 

a  collateral  branch,  has  been  developed. 

Conclusion.  ^j^g   general  truths  of   Biology  a  e   all 

there  in  the  Ayurveda ;   but  the   special  truths  from  medicine 


INTRODUCTION.  XI 

have  been  given  so  great  a  prominence  that  the  real  character 
of  the  book  has  been  over-shadowed  and  it  has  been  trans- 
formed into  a  Science  of  Medicine. 

******* 

With  a  view  to  convey  to  the  minds  of  our  readers 
an  idea  of  the  different  branches  of  the  Medical  Science 
which  developed  as  a'collateral  branch  of  this  great  Science  of 
Life,  we  would  here  touch  upon  a  few  of  them  in  passing. 

Magnetism    had   formed  its    way  into  the  therapeutics  of 

the   ancient  Hindus  and  animal  magne- 

Masnetism.  .    ,  •     ,    . 

tism  was  very   extensively   practised   in 

India  long  before  they  were  recognised  by  Mesmer  in  Germany 

and  subsequently  by  John  Elliotson  in  England. 

The  Indian  writers  on  Medical  Science  of  the  good 
old  days  have  described  in  length  the 
medicinal  properties  of  the  waters  of 
the  principal  rivers,  lakes,  water-falls  and  mineral  springs  of 
the  country  that  were  known  at  the  time  and  their  respec- 
tive curative  powers  as  applied  to  various  ailments  that 
human  flesh  is  heir  to.  This  goes  a  long  way  to  establish 
the  fact  that  Hydropathy  was  known  in  India  long  before 
it  was  even  dreamt  of  in  the  Western  world. 

The  ancient  Hindu  sages  from  time  immemorial  had 
been     cognizant     of    the    benefits    of 

assage.  massage    and    shampooing   and    taken 

to  practising  them.  Whereas,  it  is  but  of  late  that  the 
advantages  of  these  methods  have  begun  to  be  appreciated 
by  the  Western  Medical  School  and  it  no  longer  hesitates 
to  acknowledge  them  as  efficacious  therapeutic  agents. 

The  Science  of  begetting  healthy  and  beautiful  children, 

which  is  just  beginning  to  receive  atten- 
Genesiology.  ... 

tion  m  other  countries  was  not  un- 
known to  the  ancient  Hindus,  and  Manu  in  his  Mdnava- 
dharma-Sdstra  has  laid  down  special  injunctions  which  still 
form  an  integral  part  of  the  domestic  life  of  the  orthodox 
section  of  the   community.     As  a  matter   of  fact,  they  knew 

C 


Xll  INTRODUCTION. 

that  mental  impressions  of  the  parents  at  the  time  of  con- 
ception exercise  a  great  influence  over  the  future  destiny 
of  the  child  in  embryo. 

Thus  we  read  in  the  Sastras  : — "A  woman^  though  at  a 
distance,  conceives  a  child  of  the  shape  of  the  person  she 
loves  ardently  and  thinks  of  at  the  time.  Just  as  a  tree  that 
grows  is  not  different  from  the  parent  tree  whether  we  plant 
a  branch  or  sow  a  seed,  so  the  main  features  of  the  child 
partake  of  the  features  of  its  father,  though  there  might  be 
slight  changes  due  to  the  soil." 

The  subtle  soul  co-operates  with  the  Manas  (the  mind)  ; 
the  mind  co-operates  with  the  senses  ;  the  senses  perceive 
objects  3  all  this  takes  place  in  little  or  no  time.  The  above 
is  the  connection  between  the  soul  and  objects  around  us. 
What  is  there  which  the  mind  cannot  comprehend  ?  There- 
fore, wherever  the  mind  enters,  the  soul  follows  it. 

"The  soul  being  subtle,  whenever  it  enters  another  soul, 
requires  some  time  and  an  effort  of  the  mind  to  know  the 
latter.  The  soul,  which  intensely  meditates  on  an  object, 
assumes  the  shape  of  that  object.''  etc,  etc. 

In  a   book  entitled   Bhoja-Prabandha  being  a  collection 

of  the  anecdotes   realating  to  the  reign 

Anaesthetics.  ^^    ^^^^.^    p^^.^^     ^^   Pandita   Ballala 

there  is  narrated  the  detail  of  an  interesting  surgical  opera- 
tion which  had  been  performed  on  the  Raja,  who  was  suf- 
fering from  an  excruciating  pain  in  the  head.  All  the 
medical  aid  obtaining  at  the  same  time  was  availed  of,  but 
in  vain  and  his  condition  became  quite  critical  when  two 
brother  physicians  accidentally  arrived  in  Dhar,  who  were 
duly  called  in.  These  physicians,  after  carefully  examining 
the  patient,  held  that  unless  surgically  treated  no  relief 
could  possibly  be  afforded  to  the  Royal  patient.  Accordingly 
they  administered   an    anaesthetic   called    Sammohini   with 

*      F/V/.?— -Baraha  Mihir's   Brihat  Samhil^  Book,    II.     Chapter  Ixxv- 
Verses  1-3. 


INTRODUCTION.  XUl 

a  view  to  render  him  insensible  and,  when  completely, 
under  the  influence  of  the  drug,  they  trephined  his  skull, 
lemoved  the  malignant  portion  of  the  brain,  the  actual  seat 
of  the  complaint,  closed  and  stitched  up  the  opening  and 
applied  a  healing  balm  to  the  wound.  Then  they  adminis- 
tered a  restoration  known  as  Sanjivani  to  the  patient, 
who,  thereupon,  regained  consciousness  and  felt  quite  at 
ease.  This  incident  (as  narrated  by  Thakur  Saheb  0/ 
Gondal  in  his  Short  History  of  Aryan  Medical  Science) 
goes  to  prove  that  the  attendant  physician  of  Buddha,  is 
likewise  recorded  to  have  practised  cranial  surgery  writh  the 
greatest  success.  Instances  of  successful  cases  of  abdominal 
section  are  also  not  rare.  Thus  it  will  appear  that  the  ancient 
Indians  knew  and  successfully  practised  surgical  operations 
which  are  regarded  now-a-days  as  the  greatest  triumphs  of 
modern  surgery.  Tiie  purpose  of  chloroform  in  the  palmy 
days  of  yore  was  used  to  be  served  by  Sammohini,  but 
there  is  hardly  a  drug  known  to  modern  Pharmacopaeias, 
corresponding  whith  Sanjivani  which  certainly  lessens  the 
chances  of  deatlis  that  at  present  sometimes  occur  under 
anaesthetics.  ..  ^ 

Let  them,  who  allege  that  the  Hiudu  system  of  the  heal- 
ing Art  is  unscientific,  now  pause  and  reflect  ere  they  make 
such  an  unwarranted  and  irresponsible  assertion.  How  can  a 
system  which  contains  so  accurate  an  account  of  the  unions  of 
bones  and  ligaments,  anastomoses  of  nerves,  veins  and 
arteries,  etc  ,  and  which  assures  the  world  of  the  existence  of 
three  crores  and  a  half  of  veins  and  arteries  in  the  human 
body  giving  facts  and  figures  thereof  with  such  mathe- 
matical precision,  be  regarded  as  being  unscientific  ? 

It  is  certainly  an  undeniable  fact  that   one  of  the  colossal 

achievements     of     modern  Western    Medical  Science   is   its 

Anatomy;   but   the   point   at    issue  is  whether  the  process  of 

laying   open   the    structures  of  the    body 

issec  xon.  with  the   lancets,    is   at  all    a   satisfactory 

method.      For,    is   it   not   a    fact   that  the  finest     and    the 


XIV  INTRODUCTION. 

minutest  arteries  of  the  skin  are  never  disclosed,  if  the  scalpel 
is  used  so  recklessly  to  remove  the  skin  all  at  once  and 
not  allowed  to  go  deeper  into  the  muscles  to  expose  the 
minute  branches  of  blood  vessels  and  nerves  that  may  happe  i 
to  lie  embedded  therein  ?  But,  on  the  contrary,  look  at  the 
process  promulgated  by  Susruta  for  demonstrating  practical 
Anatomy  !  Its  originality  and  perfection  beats  hollow  all 
the  known  methods,  although  it  was  discovered  in  almost  the 
pre-historic  age.  The  process  prescribed  by  the  Hindu 
system  is  as  follows  : — Cover  a  dead  body  with  Kusa  grass 
and  place  it  at  the  edge  of  the  water  of  a  rivulet.  After 
three  days  take  it  out  carefully,  and  gradually  take  off 
the  succsesive  layers  of  the  epidermis  and  dermis  and 
of  the  muscles  beneath  by  gently  and  lightly  rubbing  it  over 
with  a  soft  brush.  Thus  the  smallest  and  the  thinnest 
arteries,  which  have  by  this  time  swelled  and  obtained  a 
distinct  existence  are  made  palpable  everywhere  even  to 
the  minutest. 

The  process  is  termed,  as  we  have  pointed  before,  Ava- 
gharshana  by  Susruta.  The  Western  method  might  be  an 
^  easier  and  a  more  off-hand  one,  but  by  no  means  precise. 
Though  the  merit  of  discovering  this  mode 
Avagharshana.  ^^  dissection  is  due  to  Susruta,  we  are  all 
blind  to  it  and  call  Hippocrates  the  father  of  Medicine  !  It  is 
generally  believed  that  with  a  view  to  further  his  researches 
and  perfect  his  knowledge,  it  is  Hippocrates  who  inaugurated 
the  system  of  dissection  of  dead  human  bodies  and  he  did 
the  work  secretly.  Credulous  people  may  lend  a  willing  ear 
to  such  assertions  but  the  fact  is,  that  it  was  not  till  a  century 
later  that  Hirophilus  openly  resorted  to  dissection  of 
human  bodies  and  thereby  earned  an  undying  fame  in 
Europe,  obliterating  Susruta's  name  for  ever,  though,  virtually 
speaking,  he  (Susruta)  was  the  pioneer  of  dissection  and 
figured  in  the  world  more  than  a  millenium  before  the 
advent  of  Hippocrates  and  over  eleven  centuries  prior  to  tb$ 
age  of  Herophilus^ 


INTRODUCTION.  XV 

It  would  not,  perhaps,  be  out  of  place  here  to  mention 
that  Dr.  A.  F.  R.  Hoernle,  M.  A  ,  F.  R.  S ,  C.  I.  E.,  Ph.  D., 
in  his  recent  publication  on  Hindu  Osteology,  has  proved  it 
to  the  hilt,  how  systematic,  scientific,  unerring  and  exact  were 
the  researches  of  the  ancient  Hindus  and  what  a  mine  of 
resplendent  truths  lay  imbedded  in  them  !  We,  in  our  Intro- 
duction of  the  first  volume  of  this  work,  have  tried  to  prove 
how  very  superb,  salutary  and  supremely  happy  was  the  theory 
of  Vayu,  Pitta,  and  Kapha  promulgated  by  Susruta.  There 
we  have  incidentally  mentioned  that  the  Science  of  Embryo- 
logy was  not  unknown  to  the  Hindu  sages.  In  the  present 
volume  we  mean  to  prove  to  a  point  that  the  main  principles 
promulgated  in  the  Anatomy,  the  Physiology  and  the  Patho- 
logy of  Susruta  yield  in  no  way  to  the  principles  on  those 
subjects  included  by  the  modern  Western  Scientists  and 
investigators.  On  the  other  hand,  we  boldly  affirm  that  in  the 
theories  propounded  by  Susruta  some  two  thousand  years 
back  there  lies  a  fund  of  truths  which  might  well  throw  a  flood 
of  li^ht  on  the  field  of  labour  of  the  modern  scientific  men  of 
the  West.  For  is  it  not  a  fact  that  the  theories  of  Vamana 
(causing  to  eject  the  contents  of  the  stomach  by  mouth), 
Virechana  (causing  the  evacuation  of  the  intestines),  Nasya 
(causing  to  inhale  through  the  nose),  Anuvdsana  and  Asthd- 
fana  which,  in  ancient  India,  had  earned  the  appellation  of 
Pancha-Karma,  and  had  gained  universal  prevalence,  and  were 
extensively  practised  by  oriental  physicians  from  time  im- 
memorial, have,  of  late,  been  hailed  by  the  medical  authorities 
of  the  day  as  the  most  approved  and  commended  mode  of 
treatment. 

Sceptics  who  care  nor  to  examine  and  weigh  solid  facts, 
bluntly  allege  that  the  Ayurvedic  system  is  not  based 
upon  experiment  and  observation — the  keystone  of  all 
true  Science,  and  such  being  the  case  its  Anatomy,  Physio- 
logy, Pathology  and  Therapeutics  are  all  erroneous.  The 
suggestion,  cruel  and  baseless  as  it  is,  originally  emanated 
from   an    eminent   Indian   physician    who   has  earned  an  un- 


XVI  INTRODUCTION. 

enviable  reputation  by  writing  a  Treatise  on  Hindu  Materia 
Medica.  He  says  : — *'It  (the  Ayurvedic  system)  is  built  not 
so  much  upon  experiment  and  observation  as  upon  an 
erroneous  system  of  Pathology  and  Therapeutics.*'  But  such 
an  expression  would  not  stand  the  light  of  day.  Indeed 
none  but  the  ancient  Hindu  sages  did  set  a  high  value  on 
experiment  and  observation,  and  where  they  did  not  claim 
some  occult  knowledge  or  intuition,  it  is  upon  these  two  that 
they  mainly  based  all  their  knowledge. 

The  Materia  Medica  of  the  Hindus  is  really  a  marvel. 
Its  description  of  the  properties  of  drugs  belonging  to  the 
animal,  vegetable  and  mineral  kingdoms,  and  of  the  articles 
of  food  essential  to  the  maintenance  of  health  and  strength, 
its  selection  of  the  specific  dietaries  and  elimination  of  what 
are  prohibited  in  particular  ailments  are  every  day  being 
found  correct.  The  European  preparations  of  Indian  drugs 
and  diets  are  corroborative  evidence  thereof.  The  theory 
adopted  by  the  ancient  Hindus  as  the  basis  of  their  investiga- 
tion is  that  every  substance,  whether  regitable  or  animal, 
possesses  five  properties  namely, — Rasa,  Guna,  Viryya,  Vipaka 
and  Prabhava  which  lenses  alone  cannot  reveal,  nor  the  body's 
eye  after  observation  and  experiment  made  upon  rats  and 
rabbits.  And  those  who  have  opportunities  of  studying  and 
practising  both  the  Eastern  and  Western  Medical  Science 
assert  that  the  ancient  Medical  Science  of  the  Hindus  once 
reached  the  highest  standard  of  excellence  and  perfection  in 
Materia  Medica,  Therapeutics  and  Hygiene  and  was  simply 
unrivalled  and  unapproachable,  as  it  blended  Philosophy  with 
Science— the  mind's  eye  with  the  body's  eye. 

A  dispassionate  examination  of  these  facts  (and  such  as 
can  be  multiplied  to  any  extent),  will  convince  an  impartial 
reader  that  Ayurveda,  as  we  find  it  described  in  Charaka 
Samhita  and  Susrula  Samhita,  if  approached  in  a  spirit  of 
fairness  and  enquiry,  might  reveal  the  germs  of  not  a  few 
of  the  marvellous  achievement  of  the  present  age  in  the 
domain    of    Medical    Science    and    afford    to    the    assiduous 


INTRODUCTION.  XVll 

Student  a  vast  scope  and  varied  materials  for  comparision 
between  the  Eastern  and  the  Western  systems,  and  render 
material  help  in  improving  upon  the  one  with  the  aid  of 
the  other,  and  this  to  the  benefit  of  the  suffering  humanity  at 
large. 

Lastly  it  is  our  prayer,  that  if  Western  Medical  Science 
was  ever  anywise,  directly  or  indirectly,  benefited  by  the 
ancient  Medical  Science  of  the  Hindus,  it  is  but  meet 
and  fair  that  the  former  should  come  forward  to  render  all 
possible  aid  to  her  parent  Science,  and  that  as  it  is  almost 
dying  now  for  want  of  aid  and  succour  we  look  hopefully  to 
our  present  benign  Government  in  whose  power  lies  the 
means  of  its  complete  regeneration. 


PLATE  No.  I. 


Vital  points  (Marmas)  in  the  arm 
(inner  side). 


Vital  points  (Marmas)  in  the  arm 
(ouVer  side). 


'J"  indicates  the  points  recognised  in  Juijutsu. 


See  Chapter  VI,  S'arira-S'thana. 


PLATIO  No    If. 


Vital  points  (Marmas)  in  the  leg     '     Vital  points  (Marmas)  in  the  back 
(outer  side).  j  of  the  thigh  and  the  leg. 

**J"  indicates  the  points  recognised  in  Juijutsu. 


See  Chapter  VI,  S'arira-Sthana, 


CONTENTg. 


NIDANA  STHANA. 

(Sect/on  on  Pathology). 


CHAPTPR  I.  ^     , 

Diseases  of  the  Nervous  System,  etc :— The  action  of  the  V.-tyu 

in  its  normal  state. — The  Prana  V^yu— The  Udana  Vdyu — The  Samana 
V^yu — The  Vy^na  V^yu — The  Apana  Vdyu. — Descriptions  of  the  nature 
of  the  diseases — When  they  are  localised  in  the  different  parts  of  the  system. 
— Pathology  of  Vatta-rakta — Its  premonitory  symptoms — Its  prognosis. 
— Spasms — Convulsions — Epilepsy  without  Convulsions — Epilepsy  with 
Convulsions. — Hemiplegia — Its  Prognosis. — Wry-neck  or  Torticollis. — 
Facial  Paralysis — Its  Premonitory  Symptoms — Its  Prognosis. — Sciatica. — 
Erb's  Paralysis. — Synovitis  of  the  Knee-joints. — Lameness. — V^ta-Kantaka. 
— Pada-D^ha  — Pada-Harsha.  — Ams'a-s'oshaka.  —  Ear-ache. —  Deafness. — 
Nasal  voice. — Indistinct  Speech. — Tuni — Prati-tuni. — Tympanites. — Vata- 
shthili,— Pratyashthila.  ..»  ...    •  ...        Pages  1—17. 


CHAPTER  II. 

HsemorrhoidS  : — Classifications — Patholog>'— Premonitory  Symptoms. 
— VatajaType — Pittaja  Type — Kaphaja  Type — Raktaja  Type — Sannipataja 
Type — Congenital  Type. — Figwarts  or  condylomatous  growths  about  the 
genitals.— Prognosis.  .,'.  ...  ...  ...  18—24. 


CHAPTER  III. 

tJrinary  Calculii ;— General  Etiology. — Premonitory  Symptoms.— 
Leading  Indications. — S'leshmaja  As'mari — Pittaja  As'mari— Vataja  As'mari. 
—Seminal  Concretions.— Supervening  Symptoms.^ — Situation  of  the  Blad- 
der*-—How  stones  are  formed  in  the  Bladder.        ...  ...        25— 30' 


CHAPTER  IV. 

Fistula-in-ano  cand  Fistular  Ulcers  :— Classifications— Premonitory 
Symptoms.— Derivation  of  the  term  Bhagandara.— Vataja  Type— Pittaja 
Type— Kaphaja  Type— Sannipatika  Type— Traumatic  Type— S'ata-ponaka 
Type— Ushtra-griva  Type— Parisravi  Type— S'ambukavarta  Tppe— Un- 
margi  Type.— Fistulous  Pustules.— Prognosis.  ...  ...     3i~34' 


CHAPTER  V. 

Cutaneous  Affections  in  general:— Premonitory   Symptoms— 

/Etiology — Classifications. — Aruna-Kushtha — Audumbara — Rishya-jihva 
— Kapdla  Kushtha  (Macula).— Kakanaka—Pundarika—Dadru  (ring-worm) 
— Sthularushka— Eka-Kushtha  ( Ichthyosis)- Charma-dala  (Hypertrophy  of 
the  skin) — Visarpa-Kushtha — Parisarpa-Kushtha — Sidhma— Vicharchika 
(Psoriasis)— Vip^dika—Kitima  (Keloid)— Pama  (Eczema)— Kachchhu— 
Rakasa  (Dry  Erythema) — Kilasa. — Congenital  cause  of  Kushtha. — 
Prognosis. — How  Kushtha  becomes  contageous. — Some  other  contagious 
diseases  enumerated.  ...  ...  ...  •••     35 — 42' 


CHAPTER  VI. 

Diseases  of  the  Urinary  tracts  :— Pathology— Premonitory  Symp- 
toms.— General  characteristics. — Kaphaja  Type — Pittaja  Type — Vataja 
Type. — Names  and  Symptoms  of  Kaphaja  Meha — Sura-meha — Lavana- 
meha — Pishta-meha — Sandra-meha — S'ukra-meha.  — Names  and  Symptoms 
of  Pittaj  a  Meha — Nila-Meha — Haridra-meha — Amla-meha — Ksh^ra-Meha 
— Manjishtha-meha — Rakta-meha. — Names  and  Symptoms  of  Vsttaja  Meha 
— Sarpir-mcha — Vasa-meha —  Kshaudra-meha —  Hasti-meha. —  Supervening 
Symptoms. — Kaphaja  Types — Pittaja  Types — Vataja  Types. — Abscesses. — 
Carbuncles. — Pimples. — Pustules,  etc.,  due  to  Prameha. — Prognosis. — 
Symptoms  of  Madhu -Meha.  .. .  ...  ...  ...     43—49. 


CHAPTER  Vn. 

Dropsy  with  an  abnormal  condition  of  the  abdomen: — Classifications. — 
t»redisposing  causes.— Premonitory  Symptoms.— Vataja,  Pittaja  and 
Kaphaja  Types.— Tridoshaja  Type. — Enlargement  of  the  Spleen  and  the 
Liver  with  dropsy  of  the  AMomen.  — Vaddha-gudodara — Parisrdvi-Udara. — 
Jalodara  (Ascites). — General  Characterstics  of  Dropsy. —Prognosis.   50 — 54. 


Ill 

CHAPTER  VIII. 
False  Presentations  and  Difficult  Labour  -.—Causes.— Definition. 

— Classifications    and      Symptoms.  — Abortion. — Miscarriage. — Prognosis. 

Csesarian  Section.  •  •  •  ••  ■••    55— 60. 


CHAPTER  IX 

Vidradhi  (Abscess,  etc.)  '• — Definition  and  Classification— Vataja, 
Pittaja  and  Kaphaja  Types— Sdnnipdtika  Type— Traumatic  Type— Ivaktaja 
Type— Incurable  type  of  External  Abscess.— Internal  Abscesses— Their 
localities.— Differentiating  diagnosis  of  Gulma  and  Vidradhi. — Incurable 
Type  .  ...  •■•  .-.  •••  .-.     61 — 66, 


CHAPTER  X. 
Erysipelas,  Sinus  and  Diseases  affecting  the  mammary  glands 

of  women  •• — Definition  of  Erysipelas  — Vataja,  Pittaja  and  Kaphaja  Types 
— Sannipatika  Type — Kshataja  Type.— Prognosis. — Nsidi-Vrana  (Sinus). 
— Classification — Vataja,  Kaphaja  and  Pittaja  Types — Dvandvaja  and 
Tri-doshaja  Types— S'alyaja  Type.— Stana-roga.— Breast-milk— Its 
character — Its  normal  and  abnormal  traits. — Stana- Vidradhi  (Inflammation 
of  mammary  glands).  ...  ...  ...  ...     67 — 71. 


CHAPTER  XI. 
Glands,  Scrofula,  Tumours  and  Goitre :— Dosha-origened  Glands 

— Sirdja  gland  (aneurysm  or  Varicose  Veins). — Apachi  (Scrofula*  etc.) — Its 
symptoms.  — Tumour — Its  symptoms — Blood-origined  Tumour.  — Mamsa- 
Arvuda. — Prognosis. — Adhyarvuda. — Dvirarvuda. — Cause  of  its  not  being 
suppurated.— Definition  of  Goitre— Its  specific  Symptoms— Vataja 
Goitre— Kaphaja  Goitre — Medoja  Goitre.— Prognosis.— General  shape  of 
Goitre.—  ...  ...  ...  ...  ...  73—78. 


CHAPTER  XII. 
Hydrocele,  Hernia,  Scrotal  Tumours,  Upadamsa  (disease  of  the 

ginital  organ)  and  Elephantiasis:— Classification  of  Vriddhi — Definition 
and  Premonitory  Symptoms  of  Vriddhi. — Symptoms  of  Dosha-origined 
Vriddhi.— Medoja       Vriddhi — Raktaja       Vriddhi— Hydrocele. — Inguinj^I 


IV 


Hernia.— Upadams'a— Symptoms  of.  different  Dosha-origined  types  of 
UpadamSf'a.r— Raktaja  Upadams'a.— -Definition  of  Elephantiasis. — Causes 
a,ncl  Symptoms  of  different  kinds  of  Elephantiasis. — Prognosis  of  Elephan- 
tiasis.— Localisation  of  Elephantiasis.      ...  ...  ...     79 — 84. 


CHAPTER  XIII. 
l^iseases  known  by  the  general  name  of  Kshudra-Roga  (minor 

ailrnents):— The  Names  ?ind  Symptoms  of  the  diseases  included  therein. — 
^jagallika— Yava-prakhya — Andhalaji — Vivrita— Kachchhapika — Valmika 
^— indra-vriddha— Panasikd— Pashana-Gardabha- Jala-Gaiddabha— Kak- 
sha— Vishphota — Agni-Rohini — Chippa — Kunakha— Anus'ayi — Vidarikd— 
S'arkardrbuda —  Pama —  Vicharchikd —  Rakasa —  Pdda-ddrika —  Kadara — 
Alasa — Indra-lupta  (Alopecia) — Darunaka — Arumshika— Palita— Masurika 
etc. — Tila-kalaka — Nyachchha— Charma-kila — Vyanga— Parivartika— Ava- 
patika —  Niruddha-Prakas'a —  Niiuddhat-guda —  Ahi-putana —  Vrishana- 
^achchh^— Guda-Bhrams'au ' .  j      .. ":.  '\, :,:'  ...  •  •  •     85—93. 


CHAPTER  XIV. 

■' Sukdi-dbSh,a:--^Its   classification.— Symptoms     of    different    Types. — 
iProgonsis.  ...  ..'  ...  ...  .••94 — 9^. 


CHAPTER  XV. 

Fracture  and  Dislocation,  etc  -.—Their  Causes.— General  features 
of  Sandhi-mukta  (Dislocation). — Diagnostic  Symptons  of  Dislocation. — 
TWfferent -kinds  of  Kanda-bhagna  (Fracture) — General,  symptoms  of  Kanda- 
'bhagna. — Curable  and  incurable  Types,         ...  ...  ...     97 — ioq. 


CHAPTER  XVI. 

Mukha-Roga  (Diseases  which  affect  the  cavity  of  the  mouth  in 
general).* — General  Classification  and  Localisation. — Diseases  of  the  lips. — 
Dosha-origined  Types. — Raktaja  Type— Mangsaja  Type — Medoja  Type 
— Diseases  of  the  roots  of  the  teeth.— Their  Names  and  specific  Symp- 
toms.—Danta-Nstdi  (Sinus  at  therootof  a,  tooth).— Diseases  of  the  tooth 
proper. -^Their  Names  and  specific  Symptoms. — Diseases  of  the  tongue — 
Their  Names  and  specific  Symptoms^ — Diseases  of  the  Palate— Their 
Js^mes  and   specific   Symptoms.— Diseases  of  the  Throat  and  Larnyx 


. — Their  Names  and  specific  Symptoms. — The  different   Kinds  and   Symp- 
toms of  Rohini,— Diseases  in  the  entire  cavity.      ...  ...     loi — III. 

End  of  the  contents  of  Sutra-stlisina. 


SARIRA   STHANA. 

(Section  on  Anatomy). 


CHAl  TER  1. 
The  Science  of  Being  in  General  -.—The  Twenty -four  Tattwas  or 

first  Principles. — ThePurusha  or  the  Primordial  Being  or  the  Self-conscious 
Reality.— The  Prakriti  or  the  External  Nature  personified  or  the  non* 
conscious  Eternity — Traits  of  Commonalty  and  Diversity. — Comparison  of 
the  Philosophy  of  A'yurveda  with  that  of  Samkhya  as  well  as  with  the 
other  branches  of  Philosophy. — Prakriti  and  Purusha  how  understood  in 
the  A'yurveda — Different  kinds  of  Manas  (mind). — The  five  Primary 
Elements  of  Creation — Their  specific  function— Their  mutual  co-operation 
in  creation.       ...  ...  ...  ...  ...     113 — 121. 


CHAPTER  II. 

Purification  of  Semen  and  Cataminal  fluid  etc. :— Derange- 
ment of  Semen.— Specific  treatment. — Derangement  of  Cataminal  fluid.— 
Specific  treatment. — Traits  of  pure  and  healthy  Semen  and  Cataminal  fluid, 
— Menorrhagia. — Amenorrhoea. — Their  treatment. — Regimen  to  be  ob- 
served during  Menses. — Conduct  of  husband  during  the  period. — Prohibited 
period. —Conception — Subsequent  Conduct. — Causes  of  different  Colours 
in;  the  child. — About  twins — Causes  of  the  child  being  of  Defective  Organ 
—Fecundation  without  sexual  intercourse— Causes  of  Deformity  in  the  child 
— State  of  the  Foetus — Its  activity  while  in  the  womb.  ...        122—133, 


CHAPTER  III. 

Pregnancy,  etc :— Combination  of  Self  with  the  Impregnated 
Matter. —Factors  which  determine  Sex. — Period  and  Signs  of  Menstruation. 
—Signs   of  Pregnancy. — Prohibited  conducts  during  Gestation. — Develop- 


VI 

ment  of  the  Foetus. — Longings  and  its  effects  during  pregnancy.— Develop- 
ment of  the  Foetus  from  the  Sixth  to  the  Eighth  month. — Time  of  Delivery. 
— Different  opinions  on  th3  formation  of  the  Foetal  body. — The  solution — 
Factors  respectively  supplied  by  the  Paternal  and  Maternal  Elements,  etc.— • 
External  Signs  of  Male,  Female  and  Twin  conception.  ...     134—143. 


CHAPTER  IV. 
The  development  of   Factors  in  the  womb  as  well  as  the 

Factors  which  contribute  to  the  growths  of  its  different  bodily  organs  and 
principles :— Different  folds  of  skin  over  the  foetus. — The  definition  of 
Kalas  and  their  varieties. — Seat  of  the  semen. — Why  and  how  semen  is 
discharged. — Placenta. — Formation  of  different  limbs  and  organs  of  the 
Foetal  body. — Sleep  and  its  effect. — Heart  and  its  action. — Effects  of  day- 
sleep. — Somnolence. — Effect  of  Sleep  on  an  Enciente  woman —Gnawing. 
—The  temperaments. — Symptoms  of  Vataja,  Pittaja  and  Kafaja  tempera- 
ments -  Symptoms  of  Dvandvaja  and  Sannnipatika  temperaments. — Sattvika, 
Rajasika  and  Tamasika  features.  ...  ...  ...     144 — 158. 


CHAPTER  V. 
The  Anatomy  of  the  Human  body :— Definition   of  foetus.— 

Enumeration  of  the  dfferent  Limbs  and  Membeis  of  body. — Their  Numbers— 
The  Cavities  or  Viscera. — Channels. — Kandara. — ^Jala  or  Plexuses. — Kurcha 
or  Cluster. — Sevani  or  Sutures. — Asthi-Sanghdta. — Simanta. — Bones  of 
the  four  Extremeties. — Bones  of  the  Trunk. — Bones  above  the  Cavicles — 
Different  kinds  of  Bones  and  theif  situation — Sandhi  or  Joints. — 
Joints  of  the  four  Extremities, — Sandhis  of  the  Koshtha  and  Clavicles. — 
Their  forms,  distinctions  and  locations, — The  Snayu  or  Ligaments. — 
Their  Number  and  Situations. — Muscles. — Muscles  in  the  extremities  in 
the  Koshtha — Of  the  Head  and  Neck. — Extra  Muscles  in  Women. — The 
Vaginal  Canal — The  Uterus — The  Womb. — Superiority  of  Surgery  — 
Preparations  of  dead  body — Mode  of  dissection.    ...  ..  156 — 172. 


CHAPTER  VI. 

The  Marmas  or  Vital  parts  of   the   body:— Classifications  of 

Marmas— Their  different  Numbers. — Their  Locations. — Their  Names  and 
Distributions. — The  different  Heads  of  Marmas. — Qualitative  Classes. — 
Different  opinions  on  Marmas. — Marmas  of  the  Extremities. — Marmas  of 
the  Thorax,  etc. — Marmas  in  ihe  Back. — Marmas  in  the  Clavicular  region. 
v—Jheir specific  Symptoms  when  injured.  ...  ...     173 — i^d. 


Vll 


CHAPTER  VII. 
The  Description  and  Classification  of  Sirsi  or  the  Vascular 

System: — Their  Numbers  and  action. — Names  and  Classification  of  the 
principal  Siras. — Their  specific  Locations. — The  Pitta,  Kapha,  Vayu  and 
Rakta-carrying  S:r4s.— Specific  Colours  of  Sir^s. — The  specific  Sirds  not  to 
be  punctured. — Siras  of  the  four  Extremeties,  Trunk  and  the  region  above 
the  Clavicles  and  their  roots.  ...  ...  ...     191 — 197. 


CHAPTER  VIII. 

The  method  of  Venesection  : — Persons  unfit  for  Venesection  :— 
Preliminary  Rules. — The  Jantra-Vidhi  or  how  the  patient  should  be  placed 
in  cas3s  of  Venesection. — Venesection  in  the  Extremeties. — Venesection  on 
the  diff'erent  parts  of  the  body. — Proper  and  Defective  Venesection — Classi- 
fication and  definition  of  Defective  Venesection.    ...  ...     198 — 208. 


CHAPTER  IX. 
The  Description  of  the  Arteries,  Nerves  and  Ducts  :— Region 

and  Number  of  Dhamanis. — Functions  of  the  up-coursing  Dhamanis. — 
Functions  of  the  down-coursing  Dhamanis.  -  Functions  of  the  lateral  cours- 
ing Dhamanis. — The  Situation  of  the  S rotas  and  the  specific  Symptoms 
when  pierce  1  at  the  roots.  ...  ...  ...     209 — 215. 


CHAPTER  X. 
Nursing  and  Manigement,  etc-   of  Pregnant  Women  from  the 

day  of  conception  till  parturition  :-- General  rules. — Especial  Regimen 
during  the  period  of  Gestation. — Sign  of  imminent  Parturition — Effects  of 
premature  Urging — Preliminary  Measures. --Post-parturient  Measures.— 
Natal  Rites.— Diet  for  Children. — Treatment  of  the  Mother— Makkalla  pain 
and  its  treatment. — Management  of  the  Child. — Lactation. — Selection  of 
Wet-nurses. — Examination,  etc.  of  Breast-milk. — Treatment  of  Wet-nurses. 
— Infantile  Diseases  and  their  Diagonosis — Treatment  of  Infants. — I  ifant- 
ile  Elixirs. — Nursing  of  child. — Symptoms  when  malignant  stars,  etc. 
strike  the  child.— "Eductation  and  Marriage. — Defective  Pregnancy — Its 
Symptoms  and  Medical  treatment. — Miscarriage — Its  treatment. — Manage- 
riient  of  Pregnancy  and  special  Recipe  for  Pregnant  Women  according  to 
c  months  of  Gestation.     ...  ...  ...  ..      216 — 238. 

£nd  of  the  contents  of  l^airira  Stha^na. 


Vin 


CHIKITSITA  STHANA. 

(Section  on  THERArEUTics). 


CHAPTER  I. 

The  two  kinds  of  inflamed  Ulcers:— The  Causes,  Symptoms  and 
Classification  of  Ulcers. — Idiopathic  and  Traumatic  ulcers. —General  and 
specific  Symptoms.  —Symptoms  of  different  Dosha-origined  ulcers. — Symp- 
toms of  Blood-origined  ulcers. — Symptoms  of  Suddha  Vrana. — Therapeu- 
tics.— The  sixty  different  Factors  of  medical  treatment  of  ulcers. — Upadrava 
or  the  Supervening  Symptoms  of  ulcers.  ...  ...     269 — 264. 


CHAPTER  n. 
The  medicxl  treatment  of  Traumatic  Wounds  or  Sores  :— 

Different  Shapes  and  Classifications  of  Sores. — Their  definitions — Their 
specific  Symptoms — Their  treatment.— Treatment  of  Cuts  or  Incised 
Wounds. — Treatment  of  Excised  Wounds. — Treatment .  of  Viscera  when 
perforated.— Subsequent  treatment. — Treatment  of  Diabetic  Ulcers. — 
Treatment  of  Ulcers  due  to  Kushtha  or  malignant  Ulcers.       ...     265 — 278. 


CHAPTER  HI. 
The    medical  treatment  of  Fractures  and  Dislocations  :— 

Symptoms  of  incurable  fractures. — Bandage. — Diet.— Defective  Bandaging 
—Washing. — Prrgnosis. — Treatment  of  fractures  in  particular  lir.\bs. — 
Gandha-Taila. — Suppuration  of  fractured  Bones — Symptoms  of  Complete 
union  of  fractured  Joints.  ...  ...  ...       279 — 288. 


CHAPTER  IV. 
The  medical  treatment  of  Vatta-Vystdhi  or  Nervous  disorders : 

-!— Nervous  affection  of  the  A'mas'aya — Nervous  affections  of  the  Pakvas'ayg. 
— S'alvana-upanaha. — General  Measures  beneficial  to  Vata-Vyadhi. — The 
Tilvaka-Ghrita. — The  Anu-Taila. — The  S'ata-paka  and  Sahasra-paka  Taila. 
—The  Patra-lavana.— The  Kanda  or  Sneha-lavana. — The  Kalyanaka- 
lavana.  ...  ■•■  <••  ••■  ■■•      289—296. 


IX 


CHAPTER  V. 
The    medical  treatment  of  Maha^-Vata-Vysidhi :— Causes  of 

Vata-Rakta. — Its  definition — Premonitory  symptoms — Specific  features  of 
Vata-Rakta — Prognosis. — Preliminary  remedial  measures. — Plasters  etc. — 
Treatment  of  Vata-Rakta  with  a  preponderance  of  different  Doshas. — The 
five  Pradehas— Guda-IIaritaki  and  Pippali-Vardhamana  Yogas. — Diet. — 
Regimen  of  conduct. — The  Medical  Treatment  of  Apatanaka. — Traivrita 
Ghrita. — Treatment  of  Pakshaghata. — Treatment  of  Manya-stambha. — 
Treatment  of  Apatantraka. — Treatment  of  Ardita. — Kshira-Taila. — 
Tympanites  etc. — Hingvadi-vati. — Symptoms  and  Treatment  of  Uru- 
stambha. — Therapeutic  properties  of  Guggulu.     ...  ...     297 — 315. 


CHAPTER  VI. 
The  medical  treatment  of  Ars'as  (Haemorrhoids) :— General 

remedial  measures. — Application  of  Kshara  (Alkali). — Symptoms  of 
satisfactory,  excessive  and  defective  Cauterisation.— Diet  — Rectal  Speculum. 
— Plasters. — Treatment  of  Internal  piles. — Dantyarishta. — Abhayarishta. — 
Bhallataka-yoga. — Other  forms  of  Bhallataka-yoga. — Regimen  of  diet  and 
conduct.  ...  ...  ...  ...  ...      316-328, 


CHAPTER  VII. 
The  medical  treatment  of  Asmari  (Urinary  Calculus,  etc)  :— 

Different  modes  of  treatment  in  As'mari. — Treatment  of  Vataja,  Pittaja 
and  Kaphaja  As'mari. —Alkaline  treatments.— Modes  of  Surgical  operations. 
— Prognosis. — Lithotomic  operations. — Post-surgical  measures.  — Surgical 
treatment  in  Seminal  Concretions. — Diet. — Parts  to  be  guarded  in  Litho- 
tomic operations,  ...  ...  ...  ...     329-337, 


CHAPTER  VIH. 
The  medical  treatment  of  Bhagandara  (Fistula-in-ano,  etc)  :— 

Classification. — General  treatment.  —  Specific  measures. — Different  Forms 
and  Names  of  incision. — Treatment  of  Ushtra-griva. — Treatment  of 
Parisravi. —Bhagandara  in  infants — Treatment. — Treatment  of  traumatic 
type. —Treatment  of  Tri-doshaja  type. — Syandana  Taila. — Description  of 
instrument. — Regimen  of  diet.  ...  ...  ...    338-345. 


CHAPTER  IX. 
The  medical  treatment  of  Kushtha  (Cutaneous  Affections  in 

general): — Pathology. — Conduct  of  diet  and  regimen. — Regulation  of 
diet  and  conduct. — Preliminary  treatment. — Treatment  of  Doshaja  types. — 
Maha-tikta  Ghrita. — Tikta-Sarpih. — Medicinal  plasters. — Alkaline  treat- 
ment.— Treatment  of  S'vitra. — Nila-Ghrita. — Maha-nila  Ghrita. — Treatment 
by  Bleeding,  Emetics  and  Purgatives. — Vajraka  Taila. — Maha-Vajraka 
Taila. — Treatment  by  Khadira. — Diet.  ...  ...  ...     346-361. 


CHAPTER  X. 
The  medical  treatment  of  Mahat-Kushtha  (Major  Cutaneous 

Affections).— Mantha-Kal pas. — Diet. — Medicated  Arishtas,  Asavas,  Suras 
(Wine)  and  Powders. — Medicinal  Ayas-kriti. — Aushadha  Ayas-kriti. 
— Mahaushadha  Ayas-kriti. — Khadira  preparations. ...Khadira-Sara  pre- 
parations. ...  ...  ...  »«  ...     362-371. 


CHAPTER  XI. 
The  medical  treatment  of  Prameha  (Diseases  of  the  Urinary 

tracts): — Two-fold  Classifications,  Causes  and  Symptoms.— Forbidden 
articles  of  food  and  drink.  ^Articles  of  diet. — Preliminary  treatment.— The 
five  medicinal  remedies. — Specific  treatment  of  Kaphaja  Meha  — Specific 
treatment  of  Pittaja  Meha. — Specific  treatment  of  Vataja  Meha. —Palli- 
ative measures — Medicinal  Arishtas,  Asavas,  Yavagus,  etc. — Mode  of  treat- 
ing a  poor  Prameha-patient. .. .  ...  ...  ...     372-378, 


CHAPTER  XII. 
The  medical  treatment  of  Prameha-Pidaksi  (the  Abscesses  or 

Eruptions  which  mark  the  sequel  of  a  case  of  Prameha) :— Curable  cases  of 
Prameha- Pidaka.  — Treatment.  —Dhanvantara-Ghrita.-— Fomentations  for- 
bidden in  cases  of  Madhu-meha. — S'ala-saradi  Avaleha.  —  Navaya.sa  Churna. 
— Loharishta. — Traits  of  cure.  ...  ...  ...     379-385, 


CHAPTER  XIII. 

The  medical  treatment  of  Madhu-meha  :~S'ila-jatu— Its  origin, 
properties  and  use. ^-The  Makshika-Kalpa.— The  Tuvaraka-Kalpa.  286-391. 


i 


CHAPTER  XIV. 
The  medical  treatment  of  XJdara  (Dropsy  with  an  abnormal 

condition  of  the  Abdomen)  : — Symptoms  of  curable  and  incurable  types. — 
Diet  of  articles  forbidden. — Treatment  of  Vataja,  Pittaja  and  Kaphaja 
types. — Treatment  of  Dushyodara.  — Genera]  treatment  of  Udara. — Haritaki 
Ghrita. — Maha-vriksha  Ghrita. — Chavy a  Ghrita.  —  Anaha-Vartis.  —Treat- 
ment of  Plihodara.— Shat-palaka  Ghrita. —Treatment  by  Venesection. — 
Treatment  of  Baddha-Gudodara.— Treatment  of  Parisravi  Udara.— Treat- 
ment of  Udakodara. —Treatment  by  tapping, — Diet.  ..,     392-403. 


CHAPTER  XV. 
The  medical  treatment  of  Mudha-Garbha  (Difficult  and  mal- 

presentation  of  the  Foetus  and  Difficult  Labour) : — Varieties  of  Mudha- 
Garbha.— Incantations.— Postures  of  the  Foetus. — Operations  involving 
destruction  of  the  Foetus. — Craniotomy. — After-measures. — Diet  and  regi- 
men of  conduct. —The  Bala  Taila. — The  Bala-Kalpa.  ...     404-411. 


CHAPTER  XVI. 
The  medical  treatment  of  Vidradhi  (Abscesses)  and  Tumours:— 

Classifications. — Treatment  of  Vdtaja,  Pittaja  and  Kaphaja  Vidradhi. — 
Karanjadya  Ghrita. — Treatment  of  traumatic  and  blood-origined  types. — 
Treatment  of  internal  Vidradhi. — Treatment  of  Vidradhi. — Treatment  of 
Majja-jata  Vidradhi.  ...  ...  ...  ...     412-417. 


CHAPTER  XVII. 
The  medical  treatment  of  Erysipelas  etc.,  Sinus  and  Diseases 

of  the  Mammary  Glands  *. — Classifications  of  curable  and  incurable 
types  of  Visarpa  (Erysipelas)— Treatment  of  Vataja  and  Pittaja  Visarpa. — 
Gauryadi  Ghrita. — Treatment  of  Kaphaja  Visarpa. — Treatment  of  NaCdi- 
Vrana  (Sinus). — Treatment  of  Vataja,  Pittaja,  Kaphaja  and  S'alyaja  N^di 
(Sinus). — Alkaline  treatment— Treatment  by  Plug-stick — Bhallatakadya 
Taila— Treatment  of  Stana-Roga—Purification  of  breast-milk— Surgical 
treatment  of  Stana-Roga.       ...  ...  ...  ...     418-426. 


CHAPTER  XVIII. 

The  medical   treatment   of    Granthi   (Glandular    Swellings), 
Apachi  (Scarvi),  Arvuda  (Tumour)  and  Gala-ganda  (Goitre) :— General 


Xll 

treatment  of  GrantM — Treatment  of  Vataja,  Pittaja,  Kaphaja  and  Medoja 
Granthi. — Medical  treatment  of  ApacM- — Surgical  treatment  of  Apachi. — 
Arvuda — Treatment  of  Vataja,  Pittaja,  Kaphaja  and  Medoja  types  of 
Arvuda  (Tumour), — Gala-ganda — Treatment  of  Vataja,  Kaphaja  and 
Medoja  types  of  Gala-ganda  (Goitre).  ...  ...  ...     427-438. 


CHAPTER  XIX. 

Ihe  medical  treatment  of  Vriddhi  (Hernia,  Plydrocele,  Scrotal 
Tumour,  etc.),  Upadamsa  (Diseases  of  the  Genital  Organ)  and  S'lipada 
(Elephantiasis)  -.—Treatment  of  Vataja,  Pittaja,  Raktaja,  Kaphaja, 
Medoja  and  Mutraja  Vriddhi- — Treatment  of  Antra-Vriddhi. — Treat- 
ment of  Upadams'a — General  treatment— Treatment  of  Vataja,  Pittaja, 
Kaphaja,  Tridoshaja  and  Raktaja  types  of  Upadams'a. — Treatment  of 
Slipada — General  treatment — Treatment  of  Vataja,  Pittaja  and  Kaphaja 
types  of  S'lipada — Alkaline  remedies.  ...  ...  ...     439 — 449. 


CHAPTER  XX 

The  medical  treatment  of  Kshudra-Roga  (Minor  Ailments)  :— 

Treatment  of  Aja-gallika  and  Yava-prakhya. — Treatment  of  Vivrita,  etc. — 
Treatment  of  S'arkararvuda,  etc. — Treatment  of  Pada-dari,  etc. — Treat- 
ment of  Alasa  and  Kadara. — Treatment  of  Baldness  and  Alopecia,  etc. — 
Treatment  of  Darunaka,  etc. — Treatment  of  Jatu-mani,  etc — Treatment  of 
Yuvana-pidaka — Treatment  of  the  Retroflexion  of  the  Prepuce. — Treatment 
of  the  Constriction  or  Stricture  of  the  Urethra — Its  surgical  treatment. — 
Treatment  of  the  Stricture  of  the  Anus,  etc. — Treatment  of  Valmika,  Ahi- 
putana  and  the  Prolapsus  of  the  Anus.  ...  ...     450-458. 


CHAPTER  XXI. 
The  medical  treatment  of  the  Sores  on  the  Penis  produced 

by  the  ^Uka  -.—The  specific   treatment  of  the    different   types  of  S'uka- 
dosha — General  treatment. — Prognosis.  ...  ...  ...     459-461. 


CHAPTER  XXII. 

The  medical  treatment  of  the  Affections  of  the  Mouth  :— 

Treatment   of  Vataja,    Pittaja,    Kaphaja   and    Medoja  types  of  Oshtha- 


Xlll 

kopa — Treatment  of  the  diseases  of  the  Danta-mula. — Treatment  of 
Danta-Veshta  etc. — Paridara — S'aushira — Upakus'a — Danta-Vaidarbha — 
Adhimamsa. — Treatment  of  Danta-nadi. — Treatment  of  the  diseases  of  the 
different  types  of  Tooth.  proper. — Treatment  of  Tongue-diseaseS — 
Treatment  of  Valaja,  Pittnja  and  Kaphaja  types  of  tongue-diseases — 
Treatment  of  the  different  type;:  of  Tatiu-gata  diseases — Treatment  of 
Throat-diseases. — Treatment  of  Vataja,  Pittaja,  Kaphaja  and  Raktaja 
types  of  Rohini. — Treatment  of  the  different  types  of  the  Sarva-sara 
Mukha-Roga. — Incurable  types  of  Mukha-Rcga.  ...  ...     462-474. 


CHAPTER  XXIII. 

The  medical  treatment  of  Sopha  (Swellings).— Classifications  of 
general  S'opha — Its  causes. — The  specific  symptoms  of  Dosha-origined 
types  of  S'opha. — Symptom  of  Vishaja  S'opha — Complications — Prognosis. — 
The  Special  treatment  of  the  different  types  of  S'opha. — General  remedies. 
—Diet.  ...  ...  ...  ...  ...     475-477. 


CHAPTER  XXIV. 
The  Rules  of    Hygiene  and  the  Prophilactic  Measures  :— 

Tooth-brushing — Cases  where  tooth-brushing  is  forbidden. — Eye  and  Mouth- 
washing. — Colly  rium. — S'iro'bhyanga. — Combing. — Anointing. — Parisheka. 
— Affusion. — Effusion. — Anointments. — Prohibitions  of  Anointments,  etc. — 
Physical  Exercise. — Rubbing  and  Friction. — Massage. — Bathing. — Prohibi- 
tion of  Bathing. — Anulepana. — A'lepa. — Food. — Pravata  and  ISivata.— 
vSleep — General  Rules  of  Conduct. — Rules  for  Drinking  Water,  etc. — Curd 
(Dadhi)— When  and  How  to  be  taken. — Women  unfit  to  visit. — Evil 
Effects  of  the  foregoing  Abuses.  ««  ...  ...     480-502. 


CHAPTER  XXV. 
The  medical  treatment  of  a  Variety  of  Diseases :— Diseases  of 

the  Ear-lobes— Classification — Causes  and  Symptoms — General  treatment — 
Specific  treatment. — Treatment  of  Palita. — Treatment  of  Vyanga,    etc. 

503-504. 


XIV 

CHAPTER  XXVI. 
The  medical  treatment  for  inc       ing  the  Strength  and  the 

Virile  Power  of  weak  persons  : — Definition  of  Vaji-Karana — Means  of 
Vaji-karana. — Causes  and  Symptoms  of  the  six  P'orms  of  Sexual  incapacity. 
— Incurable  types. — Remedies — Utkarika— Pupalika. — Cakes  etc.   510-514. 


CHAPTER  XXVII. 
The  Recipes  and  Modes  of  using  Elixirs  and  Rejuvenators  :— 

The  Human  Organism — Which  will  make  it  invulnerable  to  the  inroads  of 
any  Disease  and  Decay. — Time  of  using  Rasayana. — Rasayana  for  Mental 
and  Physical  maladies.  — Vidanga-Rasayana — Vidanga-kalpa.  — Kas'marya- 
kalpa. — Bala-kalpa. — Ati-bala,  Naga-bala,  Vidari  and  S'atavari-kalpa. — 
Varahi-kalpa — Use  of  S'ana  (-seeds).     ...  ...  ...     515-521. 


CHAPTER  XXVIII. 
The  Elixirs  and  Remedial  Agents  which  tend  to  improve  the 

Memory  and  invigorate  the  Mental  Faculties  as  well  as  to  increase  the 
Duration  of  Human  Life  : — S'vetavalguja -Rasayana — Krishnavalguja- 
Rasayana — Manduka-parni-Rasayana —  Brahmi-Rasayana  —  Brahmi-Ghrita 
— Vacha-Rasayana — S'ata-paka-Vacha-Ghrita. — Measures  for  prolonging 
life. — Uses  of  Gold.  ...  ...  ...  ...     522-523. 


CHAPTER  XXIX. 

The  Restorative  and  the  Constructive  Agents  which  arrest 

innate  morbific  tendencies  and  decays  : — Classifications  of  Soma. — Mode  of 
using  the  Soma. — Regimen  of  Diet  and  Conduct  after  taking  Soma. — Its 
Therapeutic  effects. — Distinctive,  features  of  the  Soma-plants — Their  des- 
criptions— Their   Habitats.     ...  ...  ...  ...     530-538. 


CHAPTPR  XXX. 
The  Tonic  Remedies  which  remove  Mental  and  Physical 

Distress  : — Persons  unfit  for  the  use  of  Rasayna. — Names  of  the  healing 
drugs. — The  Mode  of  their  use. — Regimen  of  Diet  and  Conduct — Dosage — 
Therapeutic  effects, — Differentiating  traits. — Mode  of  Culling  the  above 
drugs.— Their  Habitats. — The  common  Habitat  of  all  the  Oshadhis. 

539-545' 


XV 


CHAPTER  XXXI. 

The  medicinal  uses  of  Sneha,  etc,  :— Classifications  of  Sneha— 
Description  of  Sneha — The  specific  uses. — Measures  of  drugs. — The 
Kashaya-paka-Kalpa. — The  Sncha-p^ka-Kalpa. — Alternative  methods. — 
Application  of  Sneha  according  to  specific  Dosha  and  Season. — Degrees  of 
Cooking  a  Sneha— Distinctive  traits  of  the  complete  cooking  of  a  Sneha. — 
Process  of  Internal  Use  of  Sneha  — The  Specific  Uses  of  Clarified  butter — 
The  Dosage. — Evil  Effects  of  over-dosage — Sadyah-Sneha. — Forbidden  cases 
of    Sneha-pana.— -Good  Eff'ects  of  Sneha-pana.         ...  ...     546-557. 


CHAPTER  XXXn. 
The  medical  treatment  by  measures  of  Sveda  (Fomentations, 

Diaphoretic  measures  etc.): — Classifications  of  Sveda. — Its  Specific  Appli- 
cations.— Effects  of  Sveda. — Prohibited  cases  of  Sveda. — Symptoms  of  per- 
fect and  imperfect  Sveda. — Measures  to  be  followed  after  Sveda.      558-564. 


CHAPTER  XXXni. 

The  Distresses  which  prove  amenable  to  the  use  of  Purga- 
tives and  Emetics  : — Importance  of  Purgatives  and  Emetics. — Mode  of 
application  of  Emetics. — Symptoms  of  excessive,  satisfactory  and  deficient 
Emetics. — Effects  of  satisfactory  Emetics. — Cases  where  Emesis  is  forbid- 
den.— Cases  where  Emesis  is  recommended. — Mode  of  administering 
Purgatives. — Classifications  of  Koshtha.  —Diet. — Benefits  of  proper  Purga- 
tion.— Persons  who  should  not  be  purged. — Persons  who  should  be  purged. 
— Necessity  of  applying  Sneha  before  Ithe  administration  of  Purgative  or 
Emetic.  ...  ...  ...  ...  ...     565-589- 


CHAPTER  XXXIV. 

The  treatment  of  the  Disorders  resulting  from  an  Injudici- 
ous Use  of  Emetics  or  Purgatives  :— Their  Classes.— Cau.ses  and  treat- 
ment.— Evils  of  an  Unpurged  Residue  of  a  Purgative  or  Emetic. — Evils  of  a 
Digested  Purgative,  etc. — Evils  of  insufficient  or  excessive  expulsion  of  the 
Doshas. — Flatulent  Colic. — Partial -and  Deficient  Medication  (Ayoga). — 
Over-drugging  with  purgatives,  etc.  (Ati-yoga). — Haemorrhage  due  to 
excessive  Vomiting  or  excessive  Purging  (Jivadana). — ^Jiva-s'onita,  how 
to  be  known. — Flatulent  distention  of  the  Abdomen  (Adhmana). — Cutting 


XVI 


pain  in  the  Anus,  etc. — Dysenteric  stools  (Parisrava). — Diarrhoea 
(Pravahika). — Overwhahiiing  the  heart. — Retention  (Vibandha)  of  flatus, 
stool  and  urine.  ...  ...  ...  ...     577 — 589. 


CHAPTER  XXXV. 

The  Dimensions  and  Classifications  of  a  Netra  and  a  Vasti 
with  their  therapentic  applications  -.—The  importance  of  Vasti- 

Karma. — The  application  of  Vasti  in  different  diseases. — Dimensions  of  the 
Pipe. — Materials  of  the  Pipe. — Construction  of  the  Vasti. — Classifications  of 
the  Vasti. — Nomenclature  of  the  Vasti. — Application  of  Niruha-Vasti  and 
Asthapana-Vasti.— Their  therapeutic  Effects — The  different  Defects  of  a 
Vasti.  ...  ...  ...  ...  ...     590—598 


CHAPTER  XXXVI. 

The  medical  treatment  of  the  mishaps  which  are  consequent 
on  the  Injudicious  Application  of  the  Pipe  and  the  Vasti  :— 

Remedies  for  the  injudicious  application  of  the  Pipe. — Disorders  resulting 
from  a  defective  Vasti  (bladder)  and  its  contents. — Disorders  resulting 
from  the  defective  Position  of  the  Patient. — Remedies  for  the  Complications 
of  the  defective  position  of  Niraha-Vasti  and  Sneha- Vasti. — Intervals  for 
the  application  of  Purgative,  Emetic,  Asthapana-Vasti  and  Anuvasana- 
Vasti.  ...  ...  ...  ...  ...     599 — 607. 


CHAPTER  XXXVII. 
The  treatment  with  Anuvatsana-Vasti  and  Uttara-Vasti:— The 

Process  of  Anuvasana-Vasti — The  process  of  preparing  several  medicated 
Oils  and  Snehas. — Proper  time  for  the  application  of  Sneha-Vasti. — The 
mode  of  applying  a  Sneha-Vasti. — Symptoms  of  insufficient,  excessive,  and 
satisfactory  application  of  Anuvasana-Vasti. — Diet  after  the  application  of 
a  Vasti. — The  Successive  Actions  of  a  Vasti. — Distresses  from  Injudicious 
Application  of  Sneha-Vasti. — Specific  Symptoms — Their  remedies. — 
Uttara-Vastis — Dimensions  of  the  Pipe  of  the  Vasti  for  a  Male  and  for 
a  Female  patient. — Mode  of  application. — Vaginal  Uttara-Vasti. — Diseases 
amenable  to  Uttara-Vasti.  ...  ...  ...  ...     608 — 626, 


XVll 


CHAPTER  XXXVIII. 
The  mode   of  applying,  as  well  as  the  treatment  with  a 

Nirudha-Vasti  : — The  mode  of  Preparing  a  Vasti. — The  mode  of  Apply- 
ing a  Vasti. — Symptoms  of  a  satisfactory  application  of  a  Vasti. — Subsequent 
treatment  and  Diet  — Drugs  to  b^  used  in  a  Niruha-Vasti. — The  Formula  of 
a  Niruha-Vasti. — The  process  of  preparation. — The  Dvadasa-Prasriti. — 
Classifications  of  Vastis  according  to  the  range  of  their  therapeutic  appli- 
cations.—Corrective  Vastis. — Lekhana- Vasti. — Vaji-Karana- Vasti. —  Vrim- 
hana-Vasti. —  Pichchhila- Vasti. —  Grdhi-Vasti. —  Sneha-Vasti. —  Utkles'ana- 
Vasti.  — Dosha-hara-Vasti.  —  Soothing  Vasti.  — Yukta-ratha-Vasti. — Siddha- 
Vasti. — Must^dika-Vasti. — Variations  in  the  composition  of  Vastis  in  cases 
of  persons  of  different  Temperaments. — Nomenclature  of  different  Vastis 
and  .their  Specific    Uses.  ...  ...  ...     637 — 646. 


CHAPTER  XXXIX. 

The  treatment  of  distressing  Symptoms  which  are  manifest- 
ed in  a  patient  : — The  quantity  of  diet  to  be  taken  after  the  exhibition 
of  a  Niruha-Vasti. — Internal  application  of  Sneha  after  Blood-letting. — 
Preparations  of  different  diets. — Diet  to  be  taken  according  to  the  Dosha 
and  to  the  Strength  of  the  patient. — Regimen  of  conduct. — Articles  of  diet. 

647—652. 

CHAPTER  XL. 
The  treatment  which  consists  in  employing   the   Dhuma 

(Fumes),  Nasya  (Snuffs)  and  Kavala  (Gargles)  ;— Classifications  of 
Dhuma— Materials  ot  different  Dhuma- Varti. — Formation  of  the  Pipe  used 
in  Dhuma-Pana — Mode  of  inhalation  of  different  Dhumas — Prohibitive  cases 
—Time  of  Dhuma-pana  (Smoking) — The  therapeutic  effects  of  Dhuma- 
Pana— Mode  of  Smoking.— Snuffs  and  Errhines  (Nasya)— The  Nomen- 
clature of  the  term  "Nasya"— Classifications  of  Nasya — S'iro-Virechana— Its 
application— Dosage  of  Sneha-Nasya— Effects  of  proper,  excessive  and  defi- 
cient application  of  a  Sneha-Nasya — Avapida-Nasya — Forbidden  cases. — 
Prati-marsha  Nasya  when  to  be  used-  Its  effects. — Specific  use  of  Sneha- 
Nasya.— Kavala-graha  (Gargles)— Classification— Mode  of  application— 
Their  uses— Kavala  and  Gandusha  distinguished — How  long  Kavala 
should  be  retained — Symptoms  of  satisfactory,  deficient  and  excessive 
Gargling. — Prati-sarana — Its  classification  and  effects.  ...     653 — 671. 

End  of  the  Contents  of  the  Chikitsita  Sthatna. 


KALPASTHANA. 

(Section  on  Toxicology). 

CHAPTER  I. 
The  mode  of  Preserving  Food  and  Drink  from  the  effects  of 

Poison  : — The  necessary  qualifications  of  a  Superintendent  of  the  Royal 
Kitchen — The  necessary  features  of  a  Royal  Kitchen. — Characteristic  features 
of  a  Poisoner. — Indications  of  poisoned  food  and  drink,  etc. — General 
treatment. — The  mode  of  preparing  Soup,  etc.      ...  ...     673 — 684. 


CHAPTER  ir. 

The  Indications  (Effects,  Nature  and  Operations)  of  Sthavara 
Poisons  : — Sthavara  Poison — Its  source. — Names  of  the  different  Vegetable 
and  Mineral  poisons. — Effects  of  poison  on  the  Human  organism. — Effects 
of  Bulb-poisons — Specific  properties  and  actions  of  Bulb-poisons — Definition 
of  Dushi-visha — Symptoms  of  weak  and  slow  poisoning — Derivative 
meaning  of  Dushi-visha — Symptoms  of  the  different  stages  of  Sthavara 
Poisoning — The  medical  treatment.  — Koshatakyadi-Yavagu — Ajeya-Ghrila 
— Vishari  Agada. — Treatment  of  the  supervening  Symptoms  of  Poisoning. — 
Prognosis.         ...  ...  ...  ...  ...     685 — 694. 


CHAPTER  ni.    . 
The  Subject  of  (the  nature,  virtue,  etc.  of)  Animal  Foisons  :— 

Different  locations— Characteristic  features  and  purifications  oi  poisoned 
Water. — Poisons  in  the  Atmosphere  and  its  purification. — Mythological 
origin  of  Poison. — Properties  of  Poison — Nature  and  Location  of  Snake- 
poison— General  treatment  of  poisoning — Symptoms  of  taking  poison 
internally. — Fatal  bites. — Prognosis.    ...  ...  ...     695 — 702. 


CHAPTER  IV. 
The  Specific  Features  of  the  Poison  of  a  Snake-bite :— Clasifica- 

tions  of  Snakes — Classifications  of  Snake-bites — Their  specific  Symptoms — 
Characteristic  features  of  the  different  species  of  Snakes. — Features  of  the 
different  Castes  amongst  Snakes. — Particular  Habits  of  the  different  kinds  of 
Snakes. — Names  of  the  different  species  of  Darvi-kara  Snakes — Names  of 


XIX 


the  different  species  of  Mandali  Snakes— Names  of  the  different  species  of 
Rajim^n  Snakes — Names  of  the  different  species  of  Nirvisha  Snakes — Names 
and  Origin  of  the  different  species  of  Vaikaranja  Snakes — Sub-families  of 
the  Vaikaranja  Snakes.  — Characteristic  features  of  Male  and  Female  Snakes — 
Features  of  Iheir  bites — General  and  specific  symptoms  of  a  bite  by  a  Darvi- 
kara  Snake— Specific  symptoms  of  a  bite  by  a  Mandali  Snake— Specific 
symptoms  of  a  bite  by  a  Rdjimdn  Snake — Specific  symptoms  of  bites  by 
Snakes  of  different  Sexes  and  Ages,  etc. — Symptoms  of  the  different  stages 
of  poisoning  from  the  bites  of  a  Darvi-kara  Snake — Different  stages  of 
poisoning  from  the  bite  of  a  Mandali  Snake — Different  stages  of  poisoning 
from  the  bites  of  a  Rajiman  Snake.— The  Vegdtitara  (or  the  intervening) 
Stages. — Different  Stages  of  poisoning  in  cases  of  Lower  Animals. — 
Different  stages  of  poisoning  in  cases  of  Birds.      ...  ...     703 — 714. 


CHAPTER  V. 
The  medical  treatment   of  Snake-bites  :— General  treatment 

of  Snake-bites. — Mantras  (Incantations) — Blood-letting  in  Snake-bites — 
Specific  treatement  of  the  bite  by  a  Hooded  (Darvi-kara)  Snake,  a  Mandail 
Snake  and  a  Rajiman  Snake. — Centra-indication  to  blood-letting  in  cases  of 
Snake-bites. — Dosage  of  Collyrium,  etc.,  to  be  resorted  to  in  cases  of 
different  Beasts  and  Birds.— General  dosage  of  medicines  in  cases  of  Snake- 
bites— Specific  treatment  of  poisoning  according  to  the  Physical  Sympfoms 
— Specific  treatment  of  the  different  Supervening  Symptoms. — Remedy  for 
the  aggravated  Doshas  due  to  Poison — Medical  treatment  of  persons  made 
unconscious  from  the  effects  of  a  Fall  or  Suspended  Animation. --Symptoms 
of  wounds  from  Poisoned  Darts,  etc. — Treatment  of  a  Poisoned  Wound- 
Recipe  of  different  Agadas— Mahagada — Ajitagada — Tarkshya'gada — Risha- 
bhdgada  —  Sanjivana  Agada— Darvi-kara- Rajila-visha-hara-Agada  — Man- 
dali-visha-hara  Agada— Vams'a-tvagadi  Agada— Pancha-s'irisha  Agada— 
Sarva-Kamika  Agada— Ekasara  Agada.  ...  ...     71^ 727. 


CHAPTER    VI. 

Cases  of  Rat-poisoning  :  — Different  Varieties  of  Rats— General 
Symptoms  of  Rat-poisoning— Specific  symptoms  and  treatment  of  Rat- 
poisoning— General  treatment.— Causes  of  Rabies— Symptoms  of  Hydro- 
phobia—Prognosis. —Symptoms  of  Jala-trasa— Its  treatment— Treatment  of 
bites  by  rabid-dogs — Treatment  of  teeth  and   nail-scratching.      728 — 736. 


XX 

CHAPTER  VII. 

Treatment  with  the  Sounds  of  a  (medicated)  Drum,  etc., 
possessed  of  Anti-venomous  Virtues  :  — Ksharagada— Its  Uses  and 

Tharap^utic    Effects — Kaiyinaka-Ghri'.a — Amrita-Ghrita  ~  Maha-sugandhi 
Agad-x — Rules  of  Diet  and  Conduct. — Symptoms  of  Elimination  of  Poison. 

737—741- 


CHAPTER  VIII. 
On  insects,  i.e.,  the  measures,  etc.  to  be  adopted  in  cases  of 

Insect-bites,  etc-  : — The  Germination  and  Classification  of  Insects  — 
Insects  of  Vataja,  Pittaja,  Kaphaja  and  Sannipatika  temperaments. — 
Symptoms  of  their  Bites— The  Kanabha  class  of  Insects — The  Gaudheyaka 
class  of  Insects — S'ata-padi — Manduka  (Frogs) — Pipilika  (Ants) — Makshika 
(Stinging  Flies) — Mas'akas  (Mosquitoes). — Incurable  classes — Treatment  of 
a  bite  by  strong  and  acute- poisoned  Insects — Recipes  of  Remedies  in 
different  cases. — Origin  and  Classification  of  Scorpions — Specific  traits  and 
characteristics  of  Mild -poisoned  Scorpions,  Madhya-visha  Scorpions  and 
Tikshna-visha  Scorpions — Treatment  of  Scorpion-bites.—  Spider-bites. — 
Development  of  Luta-poison — Its  Potency — Location. —  Characteristics  of 
Poison  according  to  its  seat  in  the  body  of  a  Spider — Mythological  Account 
of  the  Origin  of  LutSu.  — The  different  names  of  Spiders  and  the  general 
Symptoms  of  their  Bodies —  Specific  Symptoms  of  Spider-bites  and  their 
Treatment — General  Remedies — Specific  symptoms  of  the  Incurable  cases  of 
Spider-bites — Their  treatment. — Surgical  Treatment— Treatment  of  Ulcers 
incidental  to  the  Bites  by  Insects  or  Snakes.  ...  ...     742 — 762. 

End  of  the  Contents  of  the  Kalpa  Sthaina. 


I 


THE 

SUSHRUTA  SAMHITA 

NIDANA  STHANAM. 


CHAPTER  I. 

Now   wc   shall   discourse   on    the   Vatavyadhl- 

(diseases  of  the  nervous  system)  Nidaaam*. 

Metrical  text:— Having  clasped  the  feet  of 
the  holy  Dhanvantari,  who  had  arisen  out  of  the 
primordial  ocean  with  the  pitcher  of  ambrosia  on  his 
head,  and  who  was  the  foremost  of  all  knowers  of  truth, 
Sus'hruta  interrogated  him  as  follows  : — "Tell  me,0  thou, 
the  foremost  of  discoursers,  all  about  the  different 
locations  and  functions  of  the  bodily  Vayu  (nerve  force), 
both  in  its  normal  and  agitated  conditions,  (as  well  as 
when  it  changes  its  natural  seat  through  a  concourse  of 
disturbing  or  aggravating  causes).  Instruct  mc  on  the 
nature  of  distempers,  which  result  from  its  deranged 
condition."     2. 

The  holy  Dhanvantari,  the  greatest  of  all  healers, 
having  listened  to  the  foregoing  words  of  Sus'hruta,  replied 
as  follows: — This  vital  Vayu  (nerve  force),  which  courses 
through   the    body,    is    self-begotten    in  its    origin,   and 

*  The  term  Nidanam,  usually  translated  as  Pathology,  is  meant  to 
include  factors,  which  fall  within  the  respective  provinces  of  Pathology, 
/Etiology,  Symptomology  and  Pathognomy  as  well.  For  the  meaning  and 
functions  of  Vayu  see  Introduction  vol.  I.  pp.  xli. — xlii. 


2  TH£   SUSHRUTA   SAMHITA.  [Chap.  I. 

is  regarded  as  identical  with  the  divine  energy  of  eternal 
life  (God),  Inasmuch  as  it  is  unconditional  and  absolute 
in  its  actions  and  effects,  eternal  and  self-origined, 
and  is  subtile  and  all-pervading  (like  the  sky  and  the 
atoms).  It  is  the  primary  factor,  which  determines  the 
principle  of  cause  and  effect  in  all  forms  of  created 
things,  whether  mobile  or  immobile.  It  is  so  called 
(Vdyu)  from  the  fact  of  its  coursing  (skr.  Va — to  move) 
throughout  the  universe.  It  determines  the  growth, 
origin  and  disintegration  of  all  animated  organisms,  and 
as  such,  it  receives  the  homage  of  all  created  beings. 
Although  invisible  in  itself,  yet  its  works  are  patent  or 
manifest.  It  is  cold,  light,  mobile,  dry  and  piercing,  and 
follows  a  transverse  course.  It  is  characterised  by  the 
two  attributes  (proper-scnsibles  or  Gunas)  of  sound  and 
touch.  It  abounds  in  the  fundamental  quality  of  Rajas 
(principle  of  cohesion  and  action),  is  of  inconceivable 
prowess,  propels  all  the  deranged  or  obstructing  prinicples 
(Doshas)  in  the  organism,  (or  in  other  words,  is  primarily 
concerned  with  the  deranged  principles  of  the  body 
which  are  pathogenic  in  their  actions).  It  is  instantaneous 
in  its  action,  and  radiates  or  courses  through  the  organ- 
ism in  constant  currents.  It  has  its  primary  field  of 
action  in  the  intestinal  tract  (Pakvadhana)  and  the 
rectum  (Guda).  In  Its  deranged  state,  it  is  the  principal 
factor,  which,  (In  combination  with  the  deranged  PIttam 
and  Kapham),  lies  at  the  root  of  all  diseases,  and  Is 
accordingly  termed  the  king  of  diseases  (Rogarat).     3. 

The   action  of   Vayu   in   its  normal 

State  : — Now,  hear  me  describe  the  symptoms,  which 
mark  the  Vayu,  as  it  courses  through  the  organism. 
The  Vdyu,  in  its  normal  or  undisturbed  condition,  main- 
tains a  state  of  equilibrium  between  the  different  Doshas 
and  the  root  principles  of  the  body   (Dhatu)  ;    it  further 


Chap.  I.]  NIDANA  STHANAM.  3 

tends  to  maintain  uniform  state  in  the  metabolism  of 
the  body,  (protoplasmic,  Agni*)  and  helps  the  organs 
of  sense-perception  in  discharging  their  specific  functions. 
The  bodily  Vayu,  like  the  Pittam  in  the  organism,  is 
grouped  under  five  different  subheads  according  to  the 
difference  in  its  functions  and  locations,  and  is  classified 
as  the  Prana,  Udana,  Samana,  Vyana  and  Apana.f 
These  five  classes  of  Vayu,  located  in  their  specific 
regions,  contribute  towards  the  integration  and  main- 
tenance of  the  body.     4 — 6 

The  Prana  Vayu  :— The  Vayu,  that  courses  in 
(governs)the  cavity  of  the  mouth, |  is  called  the  Prdna,  its 
function  being  to  force  down  the  food  into  the  cavity  of 
the  stomach,  and  to  assist  the  different  vitalising  principles 
of  the  body  (such  as  the  internal  heat  or  fire  etc.)  in  dis- 
charging their  functions  in  life,  and  to  contribute  to  the 
I  general  sustenance  of  the  body.  A  deranged  condition  of 
this  particular  kind  of  Vayu  (Pnina)  is  usually  followed 
by  hic-cough, dyspnoea  and  other  kindred  distempers.  7. 

The  Udana  Vayu  :  —The  most  Important  of  the 
vital  Vayus,  which  courses  (sends  its  vibrations)  upward, 
is  called  the  Udana.  It  produces  speech,  song,  etc.  In 
its  deranged  state  it  brings  on  diseases  which  are  speci- 
fically confined  to  regions  lying  above  the  clavicles.    8. 

The  Samana  Vayu  :— The  Samana  Vayu 
'courses  in  (governs)  the  stomach  (Amashaya)  and  in    the 

*  See  Introduction  Vol.  I.  p.p.  XLVIII— XLIX  Mahamahopadhyaya 
Dvarka  Natha  Kavlratna  interprets  this  Agni  as  digestive  heat  (/athardgni). 

t  The  Prana  Vayu  is  identical  with  the  energy  of  the  nerve  centre 
in  the  medulla  ;  the  Udana  with  that  of  the  one  which  is  situated  in  the 
speech  centre.  The  Samana  is  same  as  the  energy  of  the  epigastric 
plexus,  the  Udana  is  same  as  the  energy  of  the  Motor-Sensory  Nerves,  and 
the  Apana  is  identical  with  the  force  of  the  Hypogastric  plexus, 

X  The  field  of  its  action  includes  the  regions  of  the  heart,  throat,  bead 
and  the  nose. 


"4  THE  SUSITRUTA   SAMHITA.  tChap.  1. 

region  of  intestines  (Pakvdshaya).  Its  functions  consist  in 
digesting  the  chyme  brought  down  into  the  intestines  in 
unison  with  the  digestive  ferment  (Agni),  and  especially 
in  disintegrating  its  essence  from  its  refuse  or  excreted 
matter.  A  deranged  or  aggravated  condition  of  the 
Samana  Vayu  causes  dysentery,  Gulma,  and  impaired 
digestion,  etc.     9. 

The  Vyana  Vayu  :— The  Vayu  known  as  the 
Vyana  courses  (acts)  through  the  whole  organism,  and  its 
functions  consist  in  sending  the  lymph  chyle,  etc.  all 
through  the  body  and  in  helping  the  out-flow  of  blood 
(Asrik^  and  perspiration.  Five  kinds  of  muscular  move- 
ments* are  ascribed  to  the  action  of  the  Vyana  V^yu, 
a  deranged  condition  of  which  is  generally  attended 
with  diseases  which  are  not  confined  to  any  particular 
region,  member,  or  organ  of  the  body,  but  are  found  to 
affect  the  whole  organism  (such  as,  fever,  etc),      ro. 

The  Apana  Vayu  :— The  Vayu  known  as  the 
Apana  acts  in  the  lower  region  of  the  intestines 
(Pakvadhana).  Its  functions  consist  in  bearing  down  the 
foetus  and  the  faeces  and  in  evacuating  the  urine,  semen 
and  catamenial  blood.  An  enraged  condition  of  this  Yiyu 
tends  to  bring  on  serious  diseases,  which  are  peculiar  to 
the  urinary  bladder  and  the  distal  portion  of  the  large 
intestine  (Guda).  An  aggravated  condition  of  both  the 
Vyana  and  Apana  Vayus  may  produce  Prameha  and 
disorders  of  the  seminal  fluid,  while  a  simultaneous 
excitement  of  the  five  vital  Vayus  leads  to  a  sure  and 
speedy  termination  of  life.     11-12. 

Now  we  shall  describe  the  nature  of  diseases,  brought 

about  by  the    localization    of  the    variously   aggravated 

Vayus  in  the  different  parts  of  the  body. — In  the  cavity 

*  Such  as  expansion,  flexion,  lowering  down   ancj    lifting  up  or  lateral 
thrusting  of  any  part  of  the  body. 


Chap.  I.]  NIDANA   STIIANAM.  5 

of    the   Stomach  (Amashaya)  the   deranged    or     aggra- 
vated   Vayu  gives  rise  to  vomiting,  vertigo,  epileptic  fits, 
thirst  and  pain  at    the    sides    (Pars'va    Sula)    and    about 
the  region  of  the  heart  (Hridgraha).     In    the    intestines 
(Pakvashaya)  the  enraged  or  disturbed  Vayu   gives    rise 
to  a  rumbling  in  the  intestines,  a  piercing  pain  about  the 
region  of   the    umbilicus,   scanty    and    painful  urination 
and  stool,   or  their  entire  suppression  (Andha),  and  pain 
about  the  region  of  the  coccyx  (Trika).  13 — i  5.    Similar- 
ly, incarcerated  in  the  sense-organs,  such  as  the  cars,  etc. 
it  tends   to   deprive   them    of  their    respective  faculties. 
In  the  .skin  (lymph  chyle)  it  produces  a  discolouring  of  the 
complexion,  parchedness  and  twitching  in  the    skin,  and 
causes    a   complete   local    anaesthesia,   giving   rise  to   a 
tingling,     piercing    pain    in    the    skin,   which   spontane- 
ously bursts,  or  becomes  marked  with  cracks  and  fissures. 
Similarly,   the    aggravated    Vayu    interfering   with   the 
principle  of  blood  gives  rise  to    ulcers.     In  the    flesh,  it 
produces  painful  nodes  and  tumours  (Granthi),  while    in 
the  principle  of  fat  it  brings  on  almost  painless   tumours 
(Granthi)   unattended  with   any  kind    of  ulcer.     Incar- 
cerated in  the  veins  &c.  (Sira)  it  produces  a  stiffening   or 
painful  contraction,  or  a  varicose  or  neuralgic  condition  ; 
in  a  ligament  (Sndyu),  it  produces  numbness  (anaesthesia), 
palsy,  aching  pain  and  convulsive  jerks  ;  in  a  long  joint, 
it  tends  to  deprive  it  of  its  contractibility  and    produces 
a    painful    inflammatory   swelling    (about   the    affected 
part).    In  the  bones  it  produces    a   wasting  (atrophy)   of 
the  bones  which  crack  and  begin  to  spontaneously  burst, 
attended    with   the  characteristic  bone-ache.     Again  in 
that   important  principle  of   life,   the  marrow,  it  tends  to 
dry  it  up  and  produces  a  sort  of  pain,  extending  all  over 
the  body  which  knows  no  respite  or  abatement.  Similarly, 
in  the  principle  of  semen  it  tends  to  produce   a    scanty, 


6  THE   SUSHRUTA  SAMHITA.  [Chap.  I, 

defective,  or  excessive  emission  of  that  vital  fluid,  or  a 
complete  stoppage  thereof.     i6 — 23. 

The  Vayu,  thus  disturbed  and  agitated,  affects  in 
succession  the  lower  and  the  upper  extremities  of  the 
body,  and  the  head,  or  extends  all  over  the  body  and 
deranges  all  its  root-principles  (Dhatu).  The  symptoms, 
which  mark  such  conditions  of  the  body,  are  numbness 
(paralysis),  convulsive  contortions  of  the  limbs  (Akshepa), 
anaesthesia,  and  various  kinds  of  pain(Sula),and  swelling 
(Sop ha)  of  the  body.  The  deranged  Vdyu,  having  enter- 
ed the  natural  seats  of  the  Pittam  or  Kapham,  develops 
symptoms,  which  are  peculiar  to  either  of  them,  and 
gives  rise  to  numerous  diseases.    24 — 25. 

The  symptoms,  which  characterise  the  union  of  the 
deranged  Vayu  with  the  Pittam  (in  its  particular  seat) 
are  a  burning  sensation,  heat,  thirst,  and  loss  of  conscious- 
ness, in  addition  to  the  symptoms  of  the  Vataja  disease 
so  generated  in  that  particular  part  of  the  body,  while 
a  similar  unison  with  the  Kapham  develops  coldness, 
swelling  and  heaviness  (o(  the  affected  part).  The 
disturbed  or  agitated  Vayu  in  unison  with  the  principle 
of  blood  gives  rise  to  a  sort  of  pricking  pain  (pins  and 
needles  in  the  affected  locality),  which  can  not  bear  the 
least  touch,  or  is  marked  by  complete  anaesthesia,  and 
symptoms,  peculiar  to  the  deranged  Pittam,  follow 
in  its  train.     26 — 28. 

Vomiting,  and  a  burning  sensation,  etc.  in  the  body, 
mark  the  instance  when  the  Prana  Vayu  is  surcharged 
(Avrita)  with  the  Pittam  ;  while  weakness,  lassitude, 
somnolence  and  a  general  discolouring  of  the  com- 
plexion (  D.  R., — loss  of  taste)  characterise  a  case 
when  it  is  surcharged  with  the  deranged  Kapham  A 
burning  sensation  in  the  body,  loss  of  consciousness  or 
epileptic    fits,  and    a    sense    of  giddiness   (vertigo)   and 


Chap.    I.]  NIDANA   STllANAM.  7 

physical  languor  are  the  indications,  which  distinguish 
a  case  of  the  Udana  Vayu  being  surcharged  with  the 
Pittam  ;  while  a  stoppage  or  absence  of  perspiration, 
appearance  of  goose-flesh  on  the  skin,  impaired  diges- 
tion, coldness  and  numbness  of  the  affected  part 
characterise  a  case  of  the  same  being  surcharged  with 
the  Kapham.     29—32. 

Copious  flow  of  perspiration,  heat  with  a  burning 
sensation  in  the  body,  and  epileptic  fits  indicate  a  case 
when  the  Samana  Vayu  has  become  united  with  the 
Pittam  ;  while  a  copious  flow  of  stool  and  urine,  and 
an  excess  of  mucous  secretion  (Kapham)  from  the  nose 
(fluent  coryza)  etc.  and  horripilation  mark  a  case,  where 
it  has  become  saturated  with  the  Kapham.     33 — 34. 

Heat  and  a  burning  sensation  in  the  affected  part 
and  a  profuse  mcnorrhagia  mark  a  case  when  the 
Apana  Vayu  becomes  surcharged  with  the  Pittam,  where- 
as a  sense  of  heaviness  in  the  lower  limbs  characterises 
a  case  when  it  becomes  overcharged  with  the  Kapham. 
35—36. 

[Symptoms  such  as,]  burning  and  jerking  in  the 
limbs,  and  a  sense  of  physical  languor  become  manifest 
in  the  event  of  the  Vyana  Vayu  being  surcharged  with 
the  Pittam,  while  a  general  heaviness  of  the  limbs,  stiff- 
ness or  numbness  of  the  bone-joints,  and  an  incapability 
of  locomotion  indicate  the  fact  of  its  being  surcharged 
with  the  Kapham.  37—38. 

The  Nidanam  of  Vsita  Raktam  :— 

An  over-indulgence  in  grief,  excessive  sexual  inter- 
course, inordinate  physical  exercise,  drinking  large 
quantities  of  wine,  observance  of  a  regimen  of  diet  and 
conduct  in  a  particular  season  of  the  year  which  is  im- 
proper to  it,  use  of  articles  of  food  which  are  not  con- 
genial to  one's  own    temperament   and  an    improper   or 


^  THE   SUSHRUTA   SAMHITA.  [Chap.    I. 

baneful  use  of  such  oleaginous  substances  (as  oil,  clari- 
fied butter  etc.)  are  the  factors,  which  vitiate  in  common 
the  blood  and  Pittam  of  a  person.  The  foregoing 
causes  especially  tend  to  vitiate  or  agitate  the  Vayu 
and  blood  in  persons  of  delicate  constitutions,  or  in 
corpulent  persons,  or  in  those  who  observe  a  form  of 
perfect  continence.     39. 

The  vital  Vayu  becomes  enraged  or  agitated  by  exces- 
sive riding  on  horses,  camels  or  elephants,  or  through 
the  lifting  or  carrying  of  great  weights,  etc.,  or  by  an  in- 
ordinate indulgence  in  things  which  are  possessed  of  the 
specific  virtue  of  enraging  or  aggravating  that  vital 
principle.  On  the  other  hand,  an  over-indulgence  in 
such  articles  of  food  as  are  heat-making  in  their  potency, 
or  a  surfeit  of  edibles  largely  composed  of  sharp,  acid  or 
alkaline  substances,  as  well  as  a  large  consumption  of 
potherbs  etc.,  or  an  exposure  to  heat  tends  to  vitiate 
the  blood  of  the  organism,  and  which,  on  account  of  such 
contamination,  tends  to  speedily  obstruct  the  passage  of 
the  fleet-coursing  Vayu.  The  Vayu,  thus  impeded  in  its 
course, Ibecomes  more  and  more  agitated  each  moment, 
and  is  prone  to  speedily  agitate  the  blood  in  a  similar 
way.  The  antecedence  of  the  term  "Vata"  or  "Va}^u" 
in  the  nomenclature  of  the  disease  (Vata-Rakta)  is  owing 
to  the  precedence  accorded  to  the  action  of  the  deranged 
Vayu  in  bringing  about  the  malady,  although  it  effects 
this  In  concert  with  the  vitiated  blood  of  the 
organism.     40. 

Similarly,  the  disease  brought  about  by  the  agitated 
Pittam,  in  conjunction  with  the  vitiated  or  agitated  blood, 
is  called  the  Pitta- Raktam,  while  the  one  incidental 
to  the  combination  of  the  deranged  Kapham  with 
the  vitiated  blood  is  called  Kapha-E/aktam.  In  a  case 
of  Vata-Raktam,  the  legs,  or  the  lower  extremities    can 


Chap.  I.]  NIDANA  STHANAM.  9 

not  bear  the  least  touch  (Hyperaesthesia)  and  a  sort  of 
pricking,  piercing  pain  (pins  and  needles)  is  experienced 
in  those  regions.  The  legs  become  withered  or 
atrophied  and  lose  all  sensibility  to  touch.  In  a  case 
of  Pitta  Rakt am,  the  legs  become  extremely  red,  hot, 
soft  and  swollen,  characterised  by  a  sort  of  indescribable 
burning  sensation.  In  a  case  of  Kapha-Raktam,  the 
legs  become  swollen  and  numbed.  The  swelling  assumes 
a  whitish  hue  and  feels  cold  to  the  touch,  and  is 
accompanied  by  excessive  itching.  In  the  Sannipatika 
or  Tridoshaja  form  of  Dushta-Rakfcam,  the  legs  exhibit 
symptoms,  which  are  respectively  peculiar  to  all  the 
three  preceding  types.     41 — 43. 

Premonitory  Symptoms :  —In  the  incuba- 
tive stage  of  the  disease  the  legs  perspire  and  become 
cold  and  flabby,  or  (on  the  contrary\  the  local  perspira- 
tion is  stopped  and  the  legs  become  hot  and  hard.  More- 
over, a  pricking  pain  is  experienced  in  the  affected  parts 
which  are  marked  by  complete  anaesthesia,  heaviness,  or 
heat,  and  discolouring  of  the  skin.  The  disease  creeps 
in  either  from  the  lower  extremities,  or  in  some  cases, 
first  affects  the  upper  ones  and  gradually  extends  all 
over  the  body  like  an  enraged  rat-poison. 

Prognosis  : — The  form  of  the  disease  in  which  the 
skin  of  the  part  lying  between  the  instep  and  the  knee- 
joint  becomes  abraded  or  spontaneously  bursts  open, 
exuding  pus  and  blood,  attended  with  loss  of  strength 
(Prana)  and  flesh,  curvature  of  the  fingers,  and  eruptions 
of  nodules,  should  be  regarded  as  incurable ;  while  a 
case  of  one  year's  standing  admits  only  of  palliative 
measures.     44. 

The  enraged  or  agitated  Vayu,  while  coursing  swiftly 
through  the  Dhamanis  (nerve.s)  of  the  body,  shakes  it  in 
quick     succession,     and     a     disease,    (exhibiting     such 


10  THE  SUSHRUTA  SAMHITA.  [Chap.  I. 

symptoms  as  shaking  or  convulsive  jerks),  is  originated 
which  is  called  Akshepaka*  (spasms,  convulsions).  The 
form  of  the  disease,  in  which  the  patient  falls  to  the 
ground,  at  intervals,  is  called  ApataLnaka  (Epilepsy 
without  convulsions).  The  aggravated  or  agitated  Vayu, 
charged  with  an  abnormal  quantity  of  Kapham,  some- 
times affects  and  stuffs  the  entire  nervous  system,  and 
gives  rise  to  a  form  of  disease,  which  is  called  Dandai- 
pataiaakaTnt  (Epilepsy  with  convulsions),  inasmuch  as  it 
deprives  the  body  of  its  power  of  movement  and  flexibility, 
making  it  stiff  and  rigid  like  a  rod  (Danda).     45 — 46. 

The  disease  but  rarely  yields  to  medicine  and,  is 
cured  in  rare  instances  only  with  the  greatest  difficulty  ; 
its  characteristic  symptom  being  a  paralysis  of  the  jaw- 
bone, which  makes  deglutition  extremely  difficult.  The 
disease  in  which  the  enraged  Vayu  bends  the  body  like 
a  bow  is  called  Dhanushtambha  (Tetanus).  The  disease 
admiits  of  being  divided  into  two  distinct  types  accord- 
ingly as  the  body  of  the  patient  is  curved  internally 
(Antaraiyama,  lit:— inwardly  or  forwardly  extended, 
emprosthotonos),  or  externally  (Vahirakyatma,  lit : — ex- 
tended or  bent  on  the  back,  resting  on  his  heels  and 
occiput — Opisthotonos).  When  the  extremely  enraged 
and  powerful  bodily  Vayu  (nerve-force),  accumulated  in 

*  The  patient  suffers  from  vanishings  (idniyale)  and  loss  of  con- 
sciousness through  the  instrumentality  of  the  enraged  and  aggravated 
Vayu,  hence  the  disease  is  so  named — Gayaddsa. 

t  Jejjada  holds  that  the  enraged  Vayu,  in  unison  with  the  deranged 
Kapham,  gives  rise  to  another  kind  of  convulsions  (Akshepaka)  which  he 
has  denominated  as  Danda-patanakh  which,  exhibits  such  symptoms  as 
coldness,  swelling  and  heaviness  of  the  body  on  account  of  its  being 
brought  about  by  a  concerted  action  of  the  deranged  Pittam  and  Kapham. 
Several  authorities  aver  that  there  are  four  distinct  types  of  Akshepakah, 
such  as  Danda-patanakh,  Anlarayamah,  Vahirayamah,  and  Akshepakh 
of  traumatic  (Abhighataja)  origin. 


Chap.    I.]  NIDANA  STHANAM.  II 

the  regions  of  the  fingers,  Insteps,  abdomen,  chest,  heart 
and  throat,  forcibly  draws  in  the  local  ligaments  (Snayu), 
the  body  becomes  contracted  and  bent  forward,  bringing 
about  a  curvature  of  the  inner  trunk.  The  disease 
in  this  form  is  called  Antarayatma  Dhanushtambha. 
The  movements  of  the  eyes  become  impossible,  which 
become  fixed  in  their  sockets  ;  the  jaw-bones  become 
paralysed,  the  sides  are  broken,  and  the  patient  ejects 
(at  intervals  quantities  of)  slimy  mucous  (Kapham). 
These  are  the  features  which  mark  the  first  type 
(Antarayama  Dhanushtambha).  On  the  contrary,  when 
the  same  enraged  Vayu,  centred  or  lodged  In  ligaments 
which  traverse  the  posterior  side  of  the  body,  attracts 
them  violently,  the  body  is  naturally  bent  backward. 
The  patient  experiences  a  sort  of  breaking  pain  at 
the  chest,  waist  and  thighs,  (which  are  ultimately 
broken).  The  disease  Is  called  Vahiratyatma,  and  should 
be  looked  upon  as  beyond  the  pale  of  all  medicinal 
treatment.     47 — 50. 

Four  types  of  Akshepaka  are  usually-  recognised 
in  practice  such  as,  the  (i)  one  incidental  to  the 
concerted  action  of  the  enraged  bodily  Vayu  and 
Kapham  (2),  the  one  brought  about  through  the  union 
of  the  enraged  Vayu  with  the  deranged  Pittam,  (3), 
the  one  due  to  the  single  action  of  the  agitated  Vayu 
(4)  and  the  one  due  to  any  external  injuiy  or  blow 
(Abhighataja).*  An  attack  of  Apatdnkah  due  to  excessive 
haemorrhage,  or  following  closely  upon  an  abortion  or 
miscarriage  at  pregnancy  (difficult  labour),  or  which  is 
Incidental  to  an  external  blow  or  injury  (traumatic), 
should  be  regarded  as  Incurable.     51 — 52. 

*  Brahma  Deva  designated  the  four  types  of  the  disease,  as  Apatanakah, 
Samsrishta  Akshepakah,  simple  Akshepakah  and  the  Abhighataja 
(traumatic). 


il;2  THE   SUSHRUTA   SAMHITA.  [Chap.  I. 

The  disease,  in  which  the  extremely  agitated  Vayu 
affects  the  nerve  chains  (Dhamanis)  which  spread  either 
in  the  left  or  in  the  right  side  of  the  body,  whether  in 
the  upward,  downward,  or  lateral  direction,  making  them 
lax  and  vigourless,  and  in  which  the  joints  of  the  other 
side  of  the  body  become  useless  and  inoperative,  is  called 
Pakshfiighstta  (Hemiplegia)  by  eminent  physicians. 
The  patient,  the  whole  or  half  of  whose  body  has 
become  (almost)  inoperative  and  lost  all  sensibility,  but 
who  retains  his  consciousness  so  long  as  there  remains 
the  least  vestige  of  vitality  in  the  affected  part,  suddenly 
falls  down  and  expires.      53 — 54. 

ProgTIOSis:— -A  case  of  Pakshaghata  (Hemi- 
plegia), brought  about  through  the  single  action  of  the 
enraged  or  agitated  Vayu  of  the  body,  can  be  cured 
only  with  the  greatest  care  and  difficulty.  A  case  of 
the  same  disease,  engendered  by  the  aggravated  Vayu 
in  conjunction  with  the  deranged  Pittam  or  Kapham, 
proves  amenable  to  medicine  (Sadhya).  It  becomes  in- 
curable when  caused  through  the  waste  of  the  root  prin- 
ciples (Dhatu)  of  the  body.     55. 

Apatantrakah  (Convulsions)  :— The  Vayu, 
aggravated  (by  its  specifically  exciting  factors  and 
principles)  and  dislodged  from  its  natural  seat  or  recep- 
tacle in  the  body  in  consequence  thereof,  courses  upwards 
and  finds  lodgment  in  the  regions  of  the  head,  heart  and 
temples.  It  presses  upon  those  parts  and  gives  rise  to 
convulsive  movements  of  hands  and  legs,  or  at  times 
bends  them  down. 

Symptoms  :— The  patient  lies  with  his  eyes 
closely  shut,  or  stares  with  a  sort  of  fixed  or  vacant 
gaze,  the  eyes  remaining  fixed  or  immovable.  The 
patient  loses  all  perception,  and  groans.  Respiration 
becomes  difficult,  or   symptoms  of    temporary   asphyxia 


Chap.  I.]  NIDANA  STHANAM.  1 3 

and  unconsciousness  set  In.  Consciousness  and  a  normal 
condition  of  the  organism  return  with  the  passage 
of  the  enraged  Vayu  from  the  heart,  while  on  the 
other  hand  the  patient  relapses  into  unconsciousness 
simultaneously  with  the  envelopment  of  the  heart  with 
that  enraged  and  Kapha-e^aturated  Vayu.  This  disease 
is  called  Apatantrakah  and  is  ascribed  to  the  action 
of  the  enraged  Vayu  surcharged  with  the  deranged 
Kapham.     56. 

IVIanyastambha:— The  local  Vayu,  agitated 
through  such  causes  as  sleep  in  the  day  time,  reclining 
with  the  neck  on  an  uneven  place  or  pillow,  gazing 
upward  for  a  considerable  length  of  time,  or  looking 
aside  in  a  contorted  way,  and  enveloped  in  the  deranged 
Kapham,  gives  rise  to  the  disease  known  as  Manya- 
stambha  (wry  neck  or  torticollis).      57. 

Arditam  (Facial  Paralysis) :~*P regnant  women, 
mothers  immediately  after  parturition  (Sutika),  infants, 
old  and  enfeebled  persons  are  most  prone  to  fall  victims 
to  this  disease*.  It  has  been  also  known  to  result  from 
excessive  haemorrhage  or  loss  of  blood.  The  local  Vayu, 
extremely  enraged  or  aggravated  by  continuous  talking 
in  an  extremely  loud  voice,  chewing  of  hard  substances, 
loud  laughter,  yawning,  carrying  extremely  heavy  loads, 
and  lying  down  in  an  uneven  position  on  the  ground, 
finds  lodgment  in  the  regions  of  the  head,  nose,  upper  lip, 
chin,  forehead  and  the  joints  (inner  cornea)  of  the  eye, 
and  produces  the  disease  called  Arditam  by  distorting 
the  face. 

Symptoms  : —The  neck  and  half  of  the  face 
longitudinally  suffer  distortion  and  are  bent.  The  head 
shakes ;  the  power  of  articulating  speech  is  lost,  and    th^. 

*  The  portion  of  the  text  included  within  asterisks    has   been    reject 
by  Jejjadacharyya  as  spurious. 


14  THE   SUSHRUTA  SAMHITA.  [Chap.  I. 

eyes  are  distorted  Into  a  variety  of  shapes.  The  portions 
of  the  neck  and  the  chin,  as  well  as  the  teeth  on  the 
affected  side  become  painful. 

Premonitory  Symptoms  :— The  disease 

generally  commences  with  shivering,  horripilation, 
cloudiness  of  vision,  upcoursing  of  the  bodily  Vayu  and 
anaesthesia,  a  pricking  pain  in  the  affected  locality, 
numbness  or  paralysis  of  the  jaw-bone,  or  of  the  cervical 
muscles  of  the  neck.  Physicians,  conversant  with  the 
Etiology  of  diseases,  call  it  Arditam  (Facial  paralysis). 
Prognosis  :— A  case  of  Arditam,  appearing  in  an  ex- 
tremely enfeebled  or  emaciated  patient,  or  exhibiting 
such  symptoms  as  a  winkless  vision,  inarticulate  speech 
which  hardly  seems  to  come  out  of  the  throat,  excessive 
palsy  of  the  face,  as  well  as  the  one  of  more  than  three 
years'  standing,  should  be  deemed  as  incurable.     58. 

Gridhras'i  (Sciatica): — The  disease  in  which  the 
two  great  nerve-trunks  (Kandara),  which  emanating  from 
below  the  lower  extremity  of  the  thigh  reach  down  to 
the  bottom  of  the  insteps  and  toes,  and  become  stuffed  or 
pressed  with  the  enraged  Vayu,  thus  depriving  the  lower 
extremities  of  their  power  of  locomotion,  is  called 
Gridhras'i.      59. 

ViS'vachi  (Erbe's  paralysis  or  Bracial neuralgia):— 
The  disease  in  which  the  enraged  Vayu  affecting  the 
nerve-trunks  (Kandara)  which  run  to  the  tips  of  fingers 
behind  the  roots  of  the  upper  arms,  making  them 
[capable  of  movement  and  depriving  them  of  their 
)wer  of  flexion  or  expansion  is  called  Vis'vachi*     60. 

KrOShtukaS'irsha     (Synovitis    of    the   knee- 
Ints) : — An    extrimely    painful    swelling    in   the  knee- 
When  the    aforesaid  nerve  of  a     sirgle   arm  is  afTecld  the  disease  is 
:ted  to  it  alone,  while  it  attacks  the  both    when  both  their  nerves  are 


Chap.  I.]  NIDANA   STHANAM.  1$ 

joints,  which  is  originated  through  the  concerted  action 
of  the  deranged  Vayu  and  the  vitiated  blood  is  called 
Kroshtukas'irsha  from  the  fact  of  its  resembling  the 
head  of  a  jackal  (Kroshtuka)  in  shape.     6i, 

Khan ja  (Lameness): — The  disease  proceeds  from 
the  drawing  up  of  the  nerve  trunks  (Kandara)  of  a  leg 
by  the  deranged  Vayu  lying  about  the  region  of  the 
waist.  When  both  the  legs  are  similarly  affected,  the 
patient  is  called  a  Pangu.  He,  whose  legs  tremble  before 
starting  for  a  walk  and  who  afterwards  manages  to  go 
on  limping  is  called  a  Kalaya  Khanja  one  in  whom  the 
bone-joints  become  loose.     62 — 6^. 

Vata  Kantaka  :  -The  local  Vdyu,  enraged  by 
making  a  false  step  on  an  uneven  ground,  finds  lodg- 
ment in  the  region  of  the  ankle  (Khudaka,  instep 
according  to  others),  thus  giving  rise  to  a  disease 
which  is  called  Vata  Kantaka.  The  burning  sensation 
in  the  soles  of  the  feet  caused  by  the  enraged  local 
Vayu,  in  conjunction  with  the  deranged  Pittam  and 
blood,  is  called  Pada-daha,  which  is  generally  seen  to 
afflict  persons  of  pedestrian  habits.  When  the  legs  are 
deprived  of  all  sensibility  of  touch,  and  a  sort  of  tingling 
pain  is  experienced  in  them  it  is  termed  Padaharsha, 
which  is  due  to  the  deranged  action  of  the  Vayu  and 
Kapham.  The  disease  in  which  the  enraged  local  Vayu 
dries  up  the  normal  Kapham  lying  about  the  shoulder- 
joints  is  called  Ansa-s'hoshaka.  The  form  in  which  the 
aggravated  local  Viiyu  contracts  the  nerves  of  the  arms 
is  called  Avavahuka*.    64—67. 

Vad  hiry  ay  am  (deafness) :— The  disease  occurs 
only  when   the   deranged    Vayu,    either   singly    or   sur- 

*  The  Ansa-shosha  is  due  to  the  single  action  of  the  enraged  Vayu, 
while  Ava-vahuka  is  due  to  the  concerted  action  of  the  deranged  Vayu 
and  Kapharo, 


1 6  THE   SUSHRUTA   SAMHITA.  [Chap.  L 

charged    with   the    Kapham,   stuffs   the   sound-carrymg 
channels  (Srota)  of  the  ears.     68. 

Kama  S'ulam:— The  disease  in  which  the 
deranged  Vayu  causing  a  piercing  pain  in  the  regions  of 
the  cheekbones,  head,  temples  and  neck,  gives  rise  to  a 
sort  of  aching  pain  in  the  tympanum,  is  called  Karna- 
s'ulam  (otitis).  The  local  Vayu,  deranged  and  saturated 
with  the  Kapham  stuffing  the  nerves  (Dhamani)  which 
conduct  of  the  sound  of  speech,  produces  complete  (in 
some  cases  partial)  loss  of  the  power  of  speech — eg. 
Muka  (dumbness  ,  Minmina  (nasal  voice)  and  Gad-gada 
(indistinct  speech).     69 — 70 

A  sort  of  pain,  which  (rising  from  the  bowels  or  the 
urinary  bladder  and  ranging  downward)  gives  rise  to 
a  bursting  sensation  in  the  regions  of  the  anus  and  the 
genitals,  is  called  Tuni,  whereas  the  one,  rising  upward 
from  the  preceding  parts  and  extending  up  to  the  region 
of  the  intestines,  is  called  Prati-tuni.  A  distension 
of  the  abdomen  (Udara),  attended  with  the  incarceration 
of  flatus  (Vayu)  and  an  intense  pain  and  rumbling  in  its 
inside,  is  called  Adhmsinam  (Tympanites).  When  it  first 
affects  the  stomach  fAmasaya)  and  is  unattended  with  an 
oppressive  feeling  about  the  heart  and  pain  at  the  sides' 
it  is  called  Praty^dhmaiinam.  The  Vayu  saturated  with 
the  deranged  Kapham  causes  the  preceding  type  of 
distemper.     71—74. 

A  knotty  stone-like  tumour  (Granthi)  of  consider- 
able density,  whether  fixed  or  mobile,  and  appearing 
below  the  umbilicus, and  having  an  elevated  shape  which 
is  always  found  to  be  extended  in  an  upward  direction,  is 
called  a  VatabSthilSb,  (which)  as  its  name  implies,  is  due 
to  the  action  of  the  local  deranged  Vayu.  The  tumour, 
thus  formed,  obstructs  the  emission  of  flatus  and  impedes 
the   evacuation    of  faeces.     A  tumour  of  similar  shape, 


Chap.  I.]  NIDANA   STilANAM.  I^ 

appearing  laterally  or  across  the  region  of  the  abdomen 
(Jathara)  and  obstructing  the  passage  of  stool,  urine 
and  flatus  (Vata)  is  called  a  Pratyashthila'.     75 — ^6. 

Thus  ends  the  first  Chapter  of  the  Nidana  Sthanam  in  the  Subhruta 
Samhita,  which  treats  of  the  Nidanam  of  the  diseases  of  the  nervous 
system. 


\ 


CHAPTEE  11. 

Now  we  shall  discourse  on  the  Nidanam  of 
Ars'aS  (Haemorrhoids},     i. 

Haemorrhoids  may  be  divided  into  six  classes  viz : — 
(i)  Vdtaja  (due  to  the  action  of  the  deranged  Vayu\ 
(ii)  Pittaja  (due  to  the  action  of  deranged  Pittam),  (iii) 
Kaphaja  (due  to  the  action  of  deranged  Kapham),  (iv) 
Raktaja  (due  to  the  action  of  the  vitiated  blood),  (v) 
Samiipdtaja  (due  to  the  concerted  action  of  the  deranged 
Vayu,  Pittam  and  Kapham  i  and  (vi)  Sahaja  (congenital). 

PathoIOg^y  :  —The  deranged  Vayu,  Pittam,  etc. 
enraged  by  their  specific  aggravating  causes,  or  by  such 
acts  or  conduct  as  partaking  of  food  composed  of  in- 
compatible substances,  eating  before  the  previous  meal 
has  been  digested,  inordinate  sexual  intercourse,  sitting  on 
the  haunches,  excessive  riding,  and  the  voluntary  suppres- 
sion of  any  natural  urging  of  the  body,  either  severally 
or  in  combination  of  two  or  three  Doshas,  or  vitiating 
the  blood  of  a  person,  who  observes  no  moderation  in 
food  and  drink  &c.,  become  dislodged  from  their  natural 
seats  in  the  body  [according  to  the  law  of  Prasaranam 
(expansion  and  change  of  place  by  a  deranged  organic 
principle)]  and  are  carried  down  through  the  large 
intestine  (Pradhana  Dhamani)  into  the  descending  colon 
and  getting  lodged  therein,  give  rise  to  growths  of 
polypi  or  fleshy  condylomata,  which  are  known  as  piles. 
These  growths  chiefly  appear  in  persons  suffering  from 
impaired  digestion  (Agni),  and  gain  in  size  through 
friction  with  the  wearing  apparel,  weeds,  wood,  lumps 
of  clay  or  stone,  or  by  contact  with  cold  water.     3. 

The  lower  end  of  the  large  intestine,  which  passes 
into  the  flexure  of  the  rectum  and    measures    four   and 


Chap.    II  J  NIDANA   STHANAM.  I9 

a  half  fingers  in  length,  is  called  the  Gudam  (lit — 
the  channel  of  fecal  matter),  the  interior  of  which  is 
provided  with  three  spiral  grooves.  Each  of  these  grooves 
or  ring-like  muscles  lie  a  finger  and  a  half  apart,  and 
are  respectively  known  as  Pravdhini,  Visarjani  and 
Samvarani,  or  the  grooves  of  out-flow,  defecation  and 
closure  of  the  anus  (sphincter  ani),  covering  a  space  of 
four  fingers  and  having  laterally  an  elevation  of  one 
finger's  width.     4. 

Metrical  Texts  :— These  grooves  are  like  the 
involuted  indentures  of  a  conch  shell,  situated  one  above 
the  other,  coloured  like  the  palate  of  an  elephant.  A 
part  of  the  channel,  half  a  finger's  width  in  length  as  it 
is  usually  measured  from  the  outer  hairy  orifice  of  the 
rectum,  is  called  the  anus  (Gudoushtha).     5 — 6. 

The  first  of  the  aforesaid  grooves  or  rings  lies  about 
a  finger's  width  apart  from  the  orifice  of  the  anus. 

Premonitory  Symptoms  :~A  non-relish 

for  food,  a  tardy  and  difficult  digestion  of  food  (brought 
into  the  stomach),  acid  eructations,  a  sense  of  weakness 
in  the  thighs,  a  rumbling  sound  in  the  intestines,  emacia- 
tion of  the  body,  frequent  eructations,  swellings  around 
the  eyes,  a  croaking  sound  in  the  intestines,  cutting 
pain  in  the  rectum  (Guda),  apparent  indications  of  an 
attack  of  phthisis,  jaundice,  dysentery,  cough,  dyspnoea, 
vertigo,  somnolence,  excessive  sleep,  weakness  of  the 
organs  (Indriya),  are  indications  which  predict  the 
advent  of  this  disease,  and  which  become  more  marked 
with  its  progress.     7. 

The  Vataja  Type  :— Piles,  due  to  the  action 
of  the  aggravated  Vayu,  arc  non-exuding,  rose-coloured, 
and  uneven  in  their  surface.  They  resemble  the  Kadamba 
flowers  in  structure  and  are  either  tubular  or  sharp- 
pointed  like  a  needle,  sometimes  assumino-  the  shape    of 


20  THE   SUSHRUTA   SAMHITA.  [Chap.  II. 

the  wild  Tundikeri  flower.  The  stool  of  a  hsemorrhold 
patient  of  this  type  becomes  excessively  hard,  and  can 
be  evacuated  only  in  a  sitting  posture,  with  the  greatest 
pain  and  difficulty.  An  excruciating  pain  is  experi- 
enced in  the  regions  of  the  waist,  back,  sides, 
anus,  umbilicus  and  the  genitals.  Symptoms  peculiar 
to  Gulma,  Ashthila,  enlarged  spleen  and  abdominal 
dropsy  add  to  the  distress  of  the  patient,  whose  skin, 
nails,  eyes,  teeth,  face,  urine  and  stool  also  assume  a 
dark  black  colour.     8. 

The  Pittaja  Type  :— Piles,  brought  on 
through  the  action  of  the  deranged  Pittam,  are  slender, 
blue-topped,  shifting  in  their  nature,  yellowish  in  their 
hue,  or  are  coloured  like  shreds  of  liver,  resembling  in 
shape  the  tongue  of  the  Suka  bird.  They  are  thick  at 
middle,  like  barley  grains,  or  resemble  the  mouth  of 
leeches  and  secrete  a  sort  of  slimy  exudation.  The 
stool  is  marked  with  blood,  and  the  patient  complains  of 
a  painful,  burning  sensation  (in  the  rectum)  at  the 
time  of  defecation.  Fever,  with  a  burning  sensation  and 
thirst,  and  epileptic  fits,  supervene.  The  skin,  nails, 
eyes,  face,  teeth,  stool,  and  urine  of  the  patient  assume 
•  a  yellow  hue.     9. 

The  Kaphaja  Type  :— Piles,  due  to  the  action 
of  the  deranged  Kapham,  become  white,  are  sunk 
about  their  roots,  and  are  hard,  round  and  glossy.  They 
assume  a  greyish  hue  and  resemble  the  teats  of  a  cow  or 
the  stones  of  the  Karira,  or  of  a  Panasa  fruit.  These 
piles  do  not  burst,  nor  do  they  exude  any  sort  of  secretion. 
The  patient  feels  an  irresistible  tendency  to  scratch  the 
excrescences.  The  stools  become  copious  in  quantity 
and  are  charged  with  mucous  (Sleshm^),  resembling 
the  washings  of  meat.  Indigestion,  fever  with  shivering 
(Sita-jvara),    and  heaviness   of    the    head    and     oedema 


Chap.   II.]  NIDANA   STHANAM.  21 

with  a  non-relish  for  food  are  the  symptoms  which  be- 
come manifest  with  the  progress  of  the  disease.  The 
skin,  finger  nails,  eyes,  teeth,  face,  sLool  and  urine  of  the 
patient  also  assume  a  white  colour.      lO. 

The  Raktaja  Type  :- Piles  (haemorrhoids), 
having  their  origin  in  the  vitiated  condition  of  the  blood 
resemble  the  sprouts  of  the  Vata  tree  in  shape  and  are 
of  the  colour  of  red  coral,  or  the  seeds  (dark  red) 
of  Gunja  berry.  They  exhibit  all  the  symptoms, 
which  are  peculiar  to  the  Pittaja  type  of  this  disease. 
Pressed  hard  by  the  constricted  fi-eces  in  their 
passage  through  the  anus,  they  suddenly  give  rise  to  a 
hcxmorrhage  of  vitiated  (venous)  blood,  and  symptoms 
characteristic  of  excessive  bleeding  are  found  to 
supervene,     il. 

The   Sannipata    Type :- in    a    case     of 

haemorrhoids  due  to  the  concerted  action  of  the 
deranged  Vayu,  Pittam  and  Kapham,  symptoms 
characteristic  of  each  of  these  types  manifest  themselves 
in  unison.     12. 

The  Congenital  Type  :— Congenital  hemor- 
rhoids (Sahaja  Arsas)  are  usually  ascribed  to  defects  in 
the  semen  and  ovum  of  one's  parents  and  should  be 
medicinally  treated  with  an  eye  to  the  special  deranged 
Doshas  involved  in  the  case.  The  polypi  (in  this  type) 
are  hardly  visible  and  are  rough  and  yellowish,  with  their 
faces  turned  inward.  They  are  extremely  painful.  A 
person  suffering  from  this  type  of  piles  gets  thinner  and 
thinner  every  day  and  eats  but  very  little.  Large  veins 
(Sird)  appear  on  the  surface  of  the  body.  The  patient 
becomes  irritable,  the  semen  decreases  in  quantity, 
making  the  procreation  of  a  small  number  of  children 
possible  only  by  him.  The  voice  becomes  feeble,  the 
digestion  is  impaired,  and  disorders  affecting    the    head 


22  THE   SUSIIRUTA   SAMHITA.  [  Chap.    II. 

nose,  ears  and  eyes  follow.  A  croaking  sound  is 
heard  in  the  intestines,  attended  with  a  rumbling  in  the 
abdomen.  All  relish  for  food  vanishes  and  the  region 
of  the  heart  seems  to  be  smeared  with  a  kind  of  sticky 
paste  (of  mucous),  etc.     13. 

Auhoritativc  verse  on  the  subject  :— 

A  qualified  physician  should  undertake  the  medical  treat- 
ment of  haemorrhoids  which  occur  cither  about  the 
outer  or  the  middle  groove  of  the  rectum,  (in  as  much  as 
they  prove  amenable  to  medicine).  A  polypus,  appear- 
ing about  the  innermost  ring  or  groove  of  the  rectum, 
should  be  treated  without  holding  out  any  definite  hope 
of  cure  to  the  patient.     14. 

Ling'ars'aS  (Fig  warts  or  condylomatous  growths 
about  the  genitals): — The  deranged  and  aggravated 
Vayu  etc.,  finding  lodgment  in  the  genitals,  vitiate 
the  local  iiesh  and  blood,  giving  rise  to  an  itching  sensa- 
tion in  the  affected  localities.  The  parts  become  ulcerat- 
ed (through  constant  scratching)  and  the  ulcers  become 
studded  with  sprout-like  vegetations  offlesh(warts),which 
exude  a  kind  of  slimy,  bloody  discharge.  These  growths, 
or  excrescences  generally  appear  on  the  inner  margin,  or 
on  the  surface  of  the  glans  penis,  in  the  form  of  soft, 
slender  vegetations  of  skin,  resembling  the  hairs  of  a 
small  brush  (Kurchaka).  These  vegetations  ultimately 
tend  to  destroy  the  penis  and  the  reproductive  faculty 
of  the  patient. 

Bhagars'aS  :— The  deranged  Vayu  etc.  of  the 
body,  lodged  in  the  vaginal  region  of  a  woman,  gives  rise 
to  similar  crops  of  soft  polypi  in  the  passage.  They 
may  crop  up  isolated  at  the  outset,  and  (by  coalescing) 
may  assume  the  shape  of  a  mushroom,  or  an  umbrella, 
secreting  a  flow  of  slimy,  foul-smelling  blood. 

The   deranged    Vayu,    etc.    may     further    take     an 


Cbap.   II.]  MDANA   STHANAM.  ^3 

upward  course,  and  finding  a  lodgment  In  the  ears,  nose, 
mouth  and  eyes  may  produce  similar  warts  in  those 
localities.  Warts,  which  crop  up  inside  the  cavities  of 
the  ears,  may  bring  on  earache, dumbness,  and  afoul  dis- 
charge from  those  organs,  while  those  (cysts)  cropping  up 
in  the  eyes  will  obstruct  the  movement  of  the  eye-lids, 
giving  rise  to  pain  and  a  local  secretion  and  ultimately 
destroy  the  eye-sight.  Similarly,  such  growths  in  the 
nostrils  produce  catarrh,  excessive  sneezing,  shortness 
of  breath,  headache,  nasal  speech  and  the  complaint 
known  as  Futinasya.  Such  vegetations  cropping  up  in 
and  about  the  lips,  palate  or  the  larynx,  tend  to  make  the 
speech  confused  and  indistinct.  When  appearing  in  the 
mouth,  they  impair  the  faculty  of  taste,  and  diseases 
which  affect  the  cavity  of  the  n^outh  follow.  The  ex- 
cited Vyana  Vayu,  united  with  the  aggravated  Kapham, 
produces  a  kind  of  hard  papillomatous  growths  on  the 
skin  (about  the  anus)  which  are  called  the  Charmakilas 
(papillomata).*  15. 

Authoritative  verses  on  the  subject : 

—  These  Charmakilas  may  be  attended  with  a  kind  of 
pricking  pain  through  an  excess  of  the  deranged  Vdyu, 
whereas  those  which  have  their  origin  in  the  deranged 
Kapham  (lymphatics)  assume  a  knotty  shape  and  be- 
come of  the  same  colour  as  the  surrounding  skin.  On 
the  other  hand,  they  become  dry,  black  or  white,  and 
extremely  hard  through  an  exuberance  of  the  deranged 
local  blood  and  Fittam.     16. 

The  symptoms  of  polypi,  appearing  in  the  neighbour- 
hood of  the  anus,  have  been  described  in  full,  while  the 
general  characteristics  of  those,  which  are  found  to 
crop  up  around  the  genitals,  have  been  briefly  discoursed 

*     According  to  others,  Charmakilas  may  crop  up  on  the  skin  of  any 
part  of  the  b  dy. 


^4  THE   SUSMRUTA    SAMHITA.  [Chap.   II. 

upon.  An  intelligent  physician  should  ponder  over 
the  two  groups  of  symptoms  while  engaged  in  treating 
a  case  of  piles.  A  case  of  piles  exhibiting  symptoms 
peculiar  to  the  two  deranged  Doshas  is  called  the 
Samsargajam.  Six  distinct  types  of  bio-Doshaja  piles 
arc  known  in  practice.*     17. 

Prognosis  :— A  case  of  piles  due  to  the  con- 
certed action  of  the  three  deranged  Doshas  of  the  body, 
(with  its  characteristic  symptoms)  but  partially  develop- 
ed, may  be  temporarily  checked  (Yapya).  Cases,  which 
are  of  more  than  a  year's  standing,  as  well  as  those  in 
which  the  hciemorrhoids  are  due  to  the  concerted  action 
of  the  two  Doshas  (Samsargaja),  or  are  situated  in  the 
middle  groove  of  the  rectum,  may  be  cured  but  with 
the  greatest  difficulty.  Cases  of  the  Sannipatika  or 
congenital  (Sahaja)  types  .  should  be  given  up  as 
incurable.  The  Apana  Vayu,  in  a  person  whose  rectum 
is  overrun  with  such  polypus  growths,  tries  to  pass  out 
through  the  anus,  but  is  driven  back  upward,  being 
obstructed  in  its  passage  by  the  vegetations,  and  then 
mixes  with  his  Vyana  Vayu,  thus  imparing  (the  five- 
functioned)  fire  (Pittam)  in  his  body.     18-19. 

*  Such  as  (i)  the  one  due  to  the  concerted  action  of  the  deranged 
Pittam  and  Kapham,  (2)  the  one  incidental  to  the  simultaneous  derange- 
ment of  the  Vayu  and  the  Kapham,  (3)  the  one  brought  about  through  the 
disordered  condition  of  the  Vayu  and  blood,  (4)  the  one  due  to  the 
combination  of  the  deranged  Pittam  and  Kapham,  (5)  the  one  produced 
by  the  concerted  action  of  the  deranged  Pittam  and  blood,  (6)  the  one 
which  results  from  the  combined  action  of  the  deranged  Kapham 
and  blood. 

Thus  ends  the  second  Chapter  of  the  Nidanasth^nam  in  the  Sus'ruta 
Samhita  which  deals  with  the  Nidanam  of  piles. 


I 


CHAPTER  III. 

Now  we  shall  discourse  on  the  Nidanam  of  As'« 
mari  (urinary  calculi).      I. 

The  disease  admits  of  being  divided  into  four  several 
types,  such  as  the  Vdtaja,  the  Pittaja,  the  Kaphaja  and 
the  Sukraja  (Seminal)  concretions.  An  exuberance  or 
preponderance  of  the  deranged  Kapham  should  be  under- 
stood as  the  underlying  cause  of  all  invasions  of  this 
disease.    2. 

General  aBtioIOgy  :— The  Kaphah  of  a  man, 
who  neglects  to  cleanse  (Samsodhana)  the  internal 
channels  of  his  organism,  or  is  in  the  habit  of  taking 
unwholesome  food,  enraged  and  aggravated  by  its  own 
exciting  causes,  is  carried  into  the  urinary  bladder. 
Here  it  becomes  saturated  with  the  urine,  and  gives  rise 
to  the  formation  of  concretions  or  gravels  in  its  cavity.  3, 

Premonitory    Symptoms:— An    aching 

pain  in  the  bladder,  with  a  non-relish  for  food,  difficulty 
in  urination,  an  excruciating  pain  in  the  scrotum,  penis, 
and  the  neck  of  the  bladder,  febrile  symptoms,  physical 
lassitude,  and  a  goat-like  smell  in  the  urine  are  the 
symptoms,  which  indicate  the  formation  of  gravel  in 
the  bladder.     4. 

Metrical  Text  ;— The  deranged  Doshas  involv- 
ed in  a  particular  case  respectively  impart  their  specific 
colour  to  the  urine,  and  determine  the  character  of  the 
accompanying  pain.  The  urine  becomes  thick,  turbid, 
and  vitiated  with  the  action  of  the  aggravated  Doshas, 
and  micturition  becomes  extremely  painful.     5. 

Leading  Indications  :— A  sort  of  excru- 
ciating pain  is  experienced  either  about  the  umbilicus, 
or     in     the     bladder,     or  at  the   median    rape    of    the 

4 


26  THE  SUSHRUTA  SAMHITA.  [Chap.  III. 

perineum,  or  about  the  penis,  during  micturition  when 
gravel  is  forming  in  the  bladder.  The  urine  is 
stopped  at  intervals  in  its  out-flow,  or  becomes  charged 
with  blood,  or  flows  out  twisted  and  scattered  like 
spray,  leaving  a  sediment  of  clear,  sandy,  red  or  yellow 
particles  of  stone,  which  resembles  a  Gomedha  gem  in 
colour.  Moreover  a  pain  is  experienced  in  the  bladder 
at  the  time  of  running  or  jumping  or  in  swimming,  or 
while  riding  on  horseback,  or  after  a  long  journey.     6. 

The  ^leshmas'mari:— Stone  or  gravel,  ori- 
ginated through  the  action  of  the  deranged  Kapham, 
saturated  with  an  excessive  quantity  of  that  Dosha  by 
the  constant  ingestion  of  phlegm-generating  (Slesh- 
mala)  substances,  increases  in  size  at  the  lower  orifice  of 
the  bladder  and  ultimately  obstructs  the  passage  of  the 
urine.  The  pressure  and  recoil  of  that  incarcerated  fluid 
on  the  walls  of  the  urinary  badder  gives  rise  to  a  kind  of 
crushing,  bursting,  pricking  pain  in  that  organ,  which 
becomes  cold  and  heavy.  A  Kapha-origined  stone  or 
gravel  is  white  and  glossy,  attains  to  a  large  size,  to 
that  of  a  hen's  egg,  and  has  the  colour  of  the  Madhuka 
flower.     This  type  is  called  S'leshmas'mari.     7. 

The     Pitta ja      As'mari  :— The    Kapham 

charged  (dried)  with  the  deranged  Pittam  becomes  hard 
(condensed)  and  large  in  the  aforesaid  way,  and  lying  at 
the  mouth  of  the  bladder  obstructs  the  passage  of  the 
urine.  The  bladder,  on  account  of  the  flowing  back  of 
the  obstructed  urine  into  its  cavity,  seems  as  if  it  has 
been  exposed  to  the  heat  of  an  adjacent  fire,  boiling 
with  the  energy  of  an  alkaline  solution.  A  kind  of 
sucking,  drawing  and  burning  pain  is  experienced  in  the 
organ.  This  type  of  As'mari  is  further  marked  by 
symptoms  which  characterise  Ushna-v^ta  (stricture). 
The  concretion  is  found    to  be  of    a    reddish,    yellowish 


Chap.  III.]  NIDANA  STHANAM.  2; 

black  colour  like  the  stone  of  the  Bhalldtaka  fruit,  or  it 
is  coloured  like  honey.  This  type  is  called  Pittaja 
As'mari.     8. 

The  Vatas'mari  :— The  deranged  Kapham 
(mucus)  inordinately  saturated  with  the  bodily  Vdyu, 
acquires  hardness  and  gains  in  dimensions,  and  these 
lying  at  the  mouth  of  the  bladder  obstructs  the  passage 
of  the  urine.  The  incarcerated  fluid  causes  extreme 
pain  in  the  organ.  The  patient  constantly  under  severe 
pain  gnashes  his  teeth  or  presses  his  umbilical  region, 
or  rubs  his  penis,  or  fingers  his  rectum  (Pdyu)  and 
loudly  screams.  A  burning  sensation  is  experienced 
in  the  penis,  and  urination,  belching  and  defecation 
become  difficult  and  painful.*  The  concretions  in  this 
type  of  As'mari  are  found  to  be  of  a  dusky  colour, 
rough,  uneven  in  shape,  hard,  facetted  and  nodular  like 
a  Kadamva  flower.  This  type  is  called  Vdtas'mari.  9. 

Infants  are  more  susceptible  to  an  attack  of  any  of 
the  three  preceding  types  of  As'mari,  inasmuch  as  they 
are  fond  of  day  sleep  or  of  food  composed  of  both  whole- 
some and  unwholesome  ingredients,  and  are  in  the  habit 
of  eating  before  the  digestion  of  a  previous  meal,  or  of 
taking  heavy,  sweet,  emollient  and  demulcent  food.  In 
children  the  bladder  is  of  diminished  size  and  poor  in 
muscular  structure.  These  facts  contribute  to  the  easy 
possibility  of  the  organ  being  grappled  (with  a  surgical 
instrument)  and  of  the  stone  being  extracted  with 
the  greatest  ease  in  cases  of  infantile  As'mari.     10. 

The  ^UkraS'mari  : — Sukras'maris  or  seminal 
concretions  are  usually  formed  in  adults  owing  to  the 
germination  of  semen  in  their  organisms.  A  sudden  or 
abrupt  stoppage  of  a  sexual  act,  or  excessive  coition 
tends  to  dislodge  the  semen  from  its    natural  receptacle 

*  Stool  and  urine  can  be  voided  only  with  the  greatest  straining. 


2^  THE   SUSHRUTA  SAMHITA.  [Chap.  III. 

in  the  body.  The  fluid  thus  dislodged,  but  not  emitted, 
finds  a  wrong  passage.  The  Vayu  gathers  up  the  fluid 
(semen),  thus  led  astray,  and  deposits  it  (in  a  round  or 
oval  shape)  at  a  place  lying  about  the  junction  of  the 
penis  and  the  scrotum  and  dries  up  the  humidity  with 
which  it  is  charged.  The  matter,  thus  formed,  condensed, 
and  hardened,  is  called  the  seminal  stone  (Sukrds'mari), 
which  then  obstructs  the  passage  of  the  urine,  giving 
rise  to  pain  in  the  bladder,  painful  micturition,  and 
swellino;  of  the  scrotum.  The  stone  vanishes  under 
pressure  in  its  seat^'.     ii — -12. 

Authoritative  verses  on  the  sub- 
ject : —Concretions,  sands  and  sediments  found  to  be 
deposited  in  the  urine  in  a  case  of  Bhashma-meha  are  but 
the  modifications,  or  attendant  symptoms  of  a  case  of 
stone  in  the  bladder  (Asmari).  The  same  group  of 
symptoms  and  the  same  kind  of  pain  are  exhibited  and 
experienced  in  a  case  of  gravel  {S'arkard)  as  in  a 
case  of  stone  (Asmari)  in  the  bladder.  The  local 
Vayu  coursing  in  its  natural  direction  helps  the  dis- 
charge of  calculi  (Asmari)  with  the  urine  in  the 
event  of  they  being  extremely  attenuated  in  structure. 
Particles  of  a  stone  broken  by  the  Vayu  are  called 
urinary  calculi  {S'arkard).  A  pain  about  the  cardiac 
recfion,  a  sense  of  weakness  and  lassitude  in  the  thiojhs, 
a  griping  pain  in  the  regions  of  the  spleen  and  liver 
(Kukshi-sula),  a  shivering  sensation,  thirst,  hiccough  or 
eructations,  darkness  or  sallowness  of  complexion, 
weakness,   emaciation  with   a  non-relish   for  food    and 

*  We  can  not  but  contemplate  with  admiration  the  fact  that  Sushruta 
was  aware  of  the  formation  of  seminal  or  spermatic  concretions  in  the 
seminal  vesicles  through  degenerative  changes  of  spermatozoa  and  other 
secretions  and  their  subsequent  calcification  as  lately  discovered  by  the 
savants  of  the  "Wesi.  — Translator 


Chap.  III.]  NIDANA   STIIANAM.  29 

impaired  digestion  are  the  symptoms  which  are 
manifest  in  a  gravel-patient.  A  gravel  {S'arkard) 
obstructed  at  the  mouth  of  the  urinary  channel  is 
detected  by  the  following  indications  : — viz.,  weakness, 
lassitude,  emaciation,  cachectic  condition  of  the  body, 
pain  over  the  hepatic  region  (Kukshi-s'ula),  a 
non-relish  for  food,  sallowness  of  complexion,  hot  and 
high  coloured  urine,  thirst,  pressing  pain  at  the  cardiac 
region  and  vomiting.      13. 

The  bladder  is  situated  in  the  pelvic  cavity,  sur- 
rounded on  its  different  sides  by  the  back,  loin  (Kati), 
umbilicus,  scrotum,  rectum  (Guda),  groins  and  penis. 
This  organ  is  provided  with  a  single  aperture  or 
opening  and  lies  with  its  mouth  downward,  covered  with 
nets  of  nerves  (Sira)  and  ligaments  (Snayu),  in  the 
shape  of  a  gourd.  The  organ  is  extremely  thin  in 
structure  ;  and  thus  situated  within  the  pelvic  cavity,  it 
is  connected,  through  its  mouth  or  external  orifice,  with 
the  rectum,  the  penis,  and  the  testes.  It  is  also  known 
by  the  name  of  Maladhara  (the  receptacle  of  impure 
matter)  and  forms  (one  of)  the  primaiy  seats  of  vital 
energy  (Prana)*.  The  urinary  ducts  (ureters)  pass  close 
by  the  large  intestines  (Pakvas'aya)  and  constantly 
replenish  the  bladder  and  keep  it  moist  with  that  waste 
product  of  the  system  in  the  same  manner  as  rivers 
carry  their  contributions  of  water  into  the  ocean. 
These  passages  or  ducts  (which  are  two)  are  found  to 
take  their  origin  from  hundreds  of  branches  (or 
mouths  tubuli  uriniferi),  which  are  not  visible  to  the 
naked  eyes,  on  account  of  their  extremely  attenuated 
structures  and  carry,  whether  in  a  state  of  sleep  or 
wakening,    the    urine   from    below   the   region   of    the 

*  The   text   has   Prdndyatanam^    which    means   that   an  injury  to  the 
urinary  bladder  may  be  attended  with  fatal  result. 


30  THE  SUSHRUTA  SAMHITA.  t^hap.  III. 

stomach-f-  (Amasaya)  into  the  bladder  keeping  it  filled 
with  this  important  fluid  of  the  body,  just  as  a  new- 
pitcher,  immersed  up  to  its  neck  in  a  vessel  full  of  water, 
is  filled  by  transudation  through  its  lateral  pores.     14. 

In  the  same  way  the  Vayu,  Kapham  and  Pittam  are 
carried  into  the  bladder  (through  their  respective  ducts 
or  channels),  and  in  unison  with  the  retained  urine,  give 
rise  to  the  formation  of  stone,  on  account  of  the  slimy 
character  of  the  deposit  produced.  Stone  is  formed  in 
the  same  way  in  the  bladder  as  sediments  are  ultimately 
deposited  from  clear  and  transparent  water  at  the  bottom 
of  a  new  pitcher  which  contains  it.  As  the  wind 
and  lightning  jointly  condense  the  rainwater  into 
hailstones,  so  the  bodily  Vayu  and  Pittam  (heat)  jointly 
contribute  to  the  condensation  of  the  Kapham  in  the 
bladder  and    transform  it  into  stone. 

The  Vayu  in  the  bladder,  coursing  in  its  natural 
downward  direction,  helps  the  full  and  complete 
emission  of  urine  ;  while  coursing  in  a  contrary  direction, 
it  gives  rise  to  various  forms  of  maladies  such  as, 
Prameha,  strangury,  as  well  as  seminal  disorders ;  in 
short,  it  produces  any  urinary  trouble  to  which  the 
bladder  may  be  subjected.     15. 

t  From  the  kidneys. 

Thus   ends  the   third  Chapter  of  the  Nidana  Sthanam  in  the  Sushruta 
Samhita  which  treats  of  the  Nidanam  of  urinary  calculi. 


CHAPTER  IV. 

Now  we  shall  discourse  on  the  Nidatnam  of  Bhag^- 
ancla.ram  (fistula  m  ano  and  fistular  ulcers),     i. 

The  deranged  Vayu,  Pittam,  Kaphah  and  Sannipatah 
(a  simultaneous  derangement  of  the  three  bodily  Doshas) 
and  extraneous  causes  (such  as  a  blow  etc.)  give  rise 
to  the  types  of  Bhagandaram  known  as  Sataponaka, 
Ushtragriva,  Parisrdvi,  Samvukdvarta  and  Unmargi. 
The  disease  is  so  named  from  the  fact  that  it  bursts 
the  rectum,  the  perineum,  the  bladder  and  the  place 
adjoning  to  them  (thus  setting  up  a  mutual  communica- 
tion between  them).  The  pustules,  which  appear  in  this 
regions  are  called  as  Pidakds  in  their  unsuppurated 
stage,  while  they  are  called  Bhagandaram  when  they  are 
in  a  stage  of  suppuration.  A  pain  about  the  sacral 
bone  and  an  itching  about  the  anus,  accompanied  by  a 
swelling  and  burning  sensation,  are  the  premonitory 
symptoms  of  this  disease.     2. 

The    ^ataponakah  Type  :— The    Vayu, 

excited,  condensed,  and  rendered  motionless  by  a  course 
of  unwholesome  food,  gives  rise  to  a  pustule  within 
one  or  two  fingers'  length  from  the  rectum  (anal 
region,  — Guda),  by  vitiating  the  flesh  (areolar  tissue) 
and  blood  (of  the  locality).  It  assumes  a  vermilion 
colour  and  is  characterised  by  a  variety  of  pricking, 
piercing  pain.  If  neglected  at  the  outset,  the  pustule  runs 
into  suppuration.  Owing  to  its  vicinity  to  the  bladder, 
the  abscess  or  the  suppurated  pustule  exudes  a  kind  of 
slimy  secretion  and  becomes  covered  with  hundreds 
of  small  sieve-like  holes,  through  which  a  constant  frothy 
discharge  is  secreted  in  large  quantities.  The  ulcer,  thus 
formed,  seerns  as  if  it  is  being  thrashed  with  a  rod,  pierced 


32  THE   SUSHRUTA   SAMHITA.  CChap.  IV. 

with  a  sharp  instrument,  cut  with  a  knife,  and  pricked  by 
needles.  The  region  of  the  anus  cracks  and  bursts,  and 
jets  of  urine,  fecal  matter,  flatus  (Vata)  and  semen 
are  emitted  through  these  sieve-like  holes.  This  type 
of  fistula  is  called  Sataponakah  (Sieve-like  fistula 
in  ano).     3. 

The  Ushtra-grivah  Type: -The  enraged 

Pittam,  carried  down  by  the  Vayu  (into  the  rectum)  finds 
lodgmeit  therein,  and  there  gives  rise  to  a  small,  raised, 
red  pustule,  which  resembles  the  neck  of  a  camel  in 
shape,  and  is  characterised  by  a  varied  kind  of  pain, 
such  as  sucking  etc.  The  pustule,  not  medicinally  treated 
at  the  beginning,  runs  into  suppuration.  The  incidental 
ulcer  seems  as  if  it  is  being  burnt  with  fire  or  alkali,  and 
emits  a  hot,  fetid  discharge.  Jets  of  urine,  flatus  (Vata), 
fecal  matter  and  semen  flow  out  of  the  ulcer  in  the 
event  of  it  not  being  healed  up  with  proper  medicinal 
remedies.     This  type  is  called  Ushtragrivah.     4. 

The  Parisravi  Type: —The  enraged  Kaphah, 
carried  down  by  the  Vayu  (into  the  rectum)  and  lodged 
therein,  gives  rise  to  a  white,  hard,  itching  pustule  in  that 
locality,  characterised  by  a  variety  of  itching  pains,  etc. 
If  neglected  at  the  outset,  it  soon  runs  into  suppura- 
tion. The  incidental  ulcer  becomes  hard  and  swollen, 
marked  by  excessive  itching ,  and  a  constant  secretion  of 
slimy  fluid.  Jets  of  urine,  fecal  matter,  flatus  and  semen 
are  emitted  through  the  ulcer  in  the  event  of  it  not 
being  well  cared  for  at  the  outset.  This  type  is  called 
Parisravi.     5. 

The  ^amvukavartah  Type  :— The  en- 
raged Vayu,  in  conjunction  with  the  aggravated  Pittam 
and  Kapham,  is  carried  down,  and  finds  lodgment  (in 
the  region  of  the  rectum),  giving  rise  to  a  pustule  of  the 
size   of  the  first   toe,   and   characterised    by   a   piercing 


Chap.  IV.]  NIDANA   STHANAM.  33 

pain,  and  burning,  itching  sensations  etc.  Such  a  pustule, 
neglected  at  the  outset,  speedily  suppurates,  and  the 
incidental  ulcer  exudes  secretions  of  diverse  colours, 
characterised  by  a  kind  of  whirling  pain,  which 
revolves  about,  in  the  direction  of  the  involuted 
indentures  (within  the  grooves  of  the  rectum)  such  as 
are  found  within  the  body  of  a  river  or  fresh  water 
mollusc.     This  is  called  Samvukavartah.     6. 

The  Unmargi  Type  :— Particles  of  bones, 
eaten  with  (cooked)  meat  by  an  imprudent,  greedy,  glut- 
tonous person,  may  be  carried  down  with  the  hard  and 
constipated  stool  by  the  Apana  Vdyu  (into  the  rectum), 
thus  scratching  or  abrading  the  margin  of  the  anus,  or 
burrowing  into  the  rectum  in  the  event  of  their  being 
evacuated  in  improper  directions  through  (transverse  or 
horizontal  postures).  The  scratch  or  abrasion  is  soon 
transformed  into  a  fetid  and  putrid  ulcer,  infested  with 
worms  and  parasites,  as  a  plot  of  miry  ground 
will  soon  swarm  with  a  spontaneous  germination  of 
similar  parasites.  These  worms  and  parasites  eat  away 
the  sides  of,  or  largely  burrow  into,  the  region  of  the 
anus,  and  jets  of  urine,  fecal  matter,  and  flatus  (VayuJ 
are  found  to  gush  out  of  these  holes.  This  type  of 
Bhagandaram  is  called  Unmargi.     7. 

Authoritative  verses  on  the  sub- 
ject:— A  pustule,  appearing  about  the  region  of  the 
anus  and  characterised  by  a  slight  pain  and  swelling, 
and  spontaneously  subsiding,  should  be  regarded  as  a 
simple  pustule,  which  is  of  a  quite  different  nature 
from  a  fistula  in  ano,  which  has  contrary  features  {i.e., 
invariably  found  to  be  attended  with  a  violent  pain 
and  swelling  etc.,  and  takes  a  long  time  to  heal). 
A  Fistula-pustule  crops  up  within  a  space  of  two 
fingers'   width    of    the   Pdyu    proper   (distal  end  of  the 

5 


34  THE  SUSHRUTA   SAMHITA.  [Chap.  IV. 

rectum),  is  sunk  at  its  root,  and  attended  with  pain 
and  febrile  symptoms.  Pain,  itching  and  burning 
sensations  are  experienced  about  the  anus  after  a  ride 
in  a  carriage,  or  after  defecation.  The  anus  becomes 
swollen,  and  the  waist  painful  in  the  premonitory  stages 
of  Bhagandaram.     8—9. 

Prognosis  : — Almost  all  the  types  of  this 
disease  (Fistula  in  anoj  yield  to  medicine  after  a 
prolonged  course  of  treatment,  and  are  hard  to  cure, 
except  the  Sannipatah  and  traumatic  ones,  which  are 
incurable.     10. 

Thus  ends  ihe  fourth    Chapter  of  the  Nidana  Sthanam  in  the  Sushrula 
Samhila,  which  treats  of  the  Nidanam  of  Fistula  in  ano  (Bhagandaram). 


CHAPTER  V. 

Now  we  shall  discourse  on  the  Nidatnam  of  Kush- 
tham  (cutaneous  affections  in  general),     i. 

Improper  diet  or  conduct;  especially  ingestion  of 
improper,  unwholesome,  indigestible,  or  inconge- 
nial  food ;  physical  exercise  or  sexual  intercourse 
immediately  after  partaking  of  any  oleaginous  subs- 
tance, or  after  vomiting  ;  constant  use  of  milk  in  com- 
bination with  the  meat  of  any  domestic,  aquatic 
or  amphibious  animal  ;  a  cold  water  bath  after  an 
exposure  to  heat ;  and  repression  of  any  natural  urging 
for  vomiting  etc.  are  the  factors  which  tend  to  derange 
and  aggravate  the  fundamental  principle  of  Vayu  in  a 
person.  The  enraged  or  aggravated  Vayu,  in  combina- 
tion with  the  agitated  Pittam  and  Kapham,  enters  into 
the  vessels  or  ducts  fSira),  which  transversely  spread 
over  the  surface  of  the  body.  Thus  the  enraged  Vayu 
deposits  the  Pittam  and  Kapham  on  the  skin  through  the 
medium  of  their  channels  and  spreads  them  over  the 
entire  surface  of  the  body.  The  regions  of  the  skin  in 
which  the  aforesaid  morbific  diatheses  are  deposited 
become  marked  with  circular  rings  or  patches.  The  mor- 
bific diatheses (Doshas),  thus  lodged  in  the  skin,  continue 
to  aggravate,  and  having  been  neglected  at  the  outset, 
tend  to  enter  into  the  deeper  tissues  and  thus  contaminate 
the  fundamental  principles  (Dhatus)  of  the  body.     2. 

Premonitory  Symptoms  :  — A  roughness 

of  the  skin,  sudden  horripilation,  an  itching  sensation  in 
the  surface  of  the  body,  excess  or  absence  of  perspiration, 
anaethesia  of  the  parts,  a  black  colour  of  the  blood,  and 
a  rapid  growth  and  expansion  of  any  ulcer  (appearing  on 
the  body)  are  the  symptoms  which  mark  the  premoni- 
tory stages  of  Kushtham.     3. 


36  THE  SUSHRUTA  SAMHITA.  tChap.  V. 

Classification  :— [Diseases,  falling  under  the 
group  of  Kushtham,  may  be  divided  into  two  broad 
subdivisions],  viz.,— Mahdktishthas  (major)  and  Kshudra 
{minor)  Kushthas,  the  first  consisting  of  seven,  and  the 
second  of  eleven  different  types,  aggregating  eighteen 
in  all.  The  Mahakushthas  are  classified  as,  Aruna, 
Audumvara,Rishya-Jihva,  Kapala,  Kakanaka,  Pundarika, 
and  Dadru.  The  minor  or  Kshudra-kushthas  (Lichen  and 
Dermatitis)  are  Sthularushkam,  Mahakushtham,  Eka- 
kushtham,  Charmadalam,  Visarpah,  Parisarpah,  Sidhma, 
Vicharchika,  Kitima,  Pama,  and  Rakasa.  All  the  types 
of  Kushtham,  whether  major  or  minor,  involve  the  action 
of  the  deranged  Vdyu,  Pittam  or  Kapham,  and  are  con- 
nected with  the  presence  of  parasites  in  those  localities  * 
The  preponderance  of  any  particular  morbific  diathesis 
(Dosha)  in  any  case  of  Kushtham  should  be  looked  upon 
as  its  originating  cause.  The  type,  known  as  Aruna 
Kushtha,  is  due  to  the  action  of  the  preponderant  Vayu  ; 
Audumvara,  together  with  Rishya-Jihva,  Kapala  and 
Kakanaka,  to  a  preponderance  of  the  deranged  Pittam  ; 
while  Pundarika  and  Dadru  owe  their  origin  to  an 
excess  of  the  deranged  Kapham.  These  types  of  major 
or  minor  Kushthas  are  successively  more  extensive  in 
their  action  and  more  incurable  on  account  of  their 
respectively  invading  a  greater  number  of  the  bodily 
elements  (Dhatus).     4 — 6. 

Mahakushthas  :— Aruna-kushtha  owes  its 
origin  to  an  exuberance  of  the  deranged  Vayu.  It  is 
slightly    vermilion-coloured,    thin  and    spreading   in  its 

*  Certain  authorities  hold  that,  all  types  of  Kushtham  (cutaneous 
affections)  to  be  of  parasitic  origin.  The  Garuda  Puranani  avers  that,  the 
parasites,  which  infest  the  external  principles  of  the  body,  are  the  primary 
causes  of  cutaneous  Sif^eclions—A'iishtAaika'heiavoniafy'dk  shlemshajd 
v6hyasambhavdli,     Ch.  CLXIXV.  4. 


Chap,  v.]  KlDANA  STHAKAM.  37 

nature.  A  sort  of  pricking,  piercing  pain  (is  experienced 
in  the  affected  locality)  which  loses  all  sensibility  to 
the  touch.  The  type  known  as  Audumbara  is  coloured 
and  shaped  like  a  ripe  or  mature  Audumbara  fruit 
and  has  its  origin  in  the  deranged  Pittam.  The  type 
called  Rishyajihva  is  rough  and  resembles  the  tongue 
of  a  Rishya  (Deer)  in  shape  and  colour.  The  type 
known  as  Kapaila  (Macula  cserula^)  resembles  a  black 
(deep  blue)  Kharpara  (  baked  clay  ).  The  Katkanaka 
type  is  characterised  by  a  dark  red  and  black  colour 
like  the  seed  of  the  Guiija  berry.  A  sort  of  sucking 
and  burning  pain  is  experienced  in  the  affected 
locality  in  all  the  four  preceding  types  of  the  disease 
which  are  the  outcome  of  the  deranged  Pittam.  The 
whole  diseased  surface  seems  as  if  burning  with  fire, 
and  emitting  hot  fumes.  They  are  speedy  in  their 
origin  and  rapidly  suppurate  and  break.  All  these 
types  soon  become  infested  with  parasites.  These 
are  the  general  features  of  these  forms  of  Kushthas.     7. 

Pundarika:— The  patches  resemble  the  petals 
of  a  (full  blown)  lotus  flower  in  colour,  and  Dadru 
(Ringworm)  assumes  the  colour  ffaint  blue)  of  an 
Atasi  flower,  or  of  copper.  They  are  spreading  in  their 
nature  and  are  found  to  be  overspread  with  pustules. 
Both  the  Dadru  and  Pundarika  types  are  raised,  circular, 
and  characterised  by  itching  and  take  a  considerable 
time  to  be  fully  patent.  These  are  the  general  charac- 
teristics of  Dadru  and  Pundarika.     8. 

Kshudra  Kushthas  :— We  shall  now  des- 
cribe (the  features  of  the  diseases  known  as)  Kshudra- 
knshthas  (M.  Text):— The  type  known  as  Sthula'rushka 
appears  about  the  joints.  It  is  extremely  thick  at  its 
base,  is  cured  with  the  greatest  difficulty,  and  is  strewn 
over  with  hard  pustules  (Arungshi).    In  the  type  known 


3^  THE  SUSHRUTA  SAMHITA.  [Chap.  V. 

as  of  Mahatkushtham  the  skin  contracts,  and  with  the 
bursting  of  the  skin  (a  piercing  pain  is  felt  in  the  affec- 
ted part),  which  loses  all  sensibility  to  the  touch,  accom- 
panied by  a  general  sense  of  lassitude  in  the  limbs.  In 
the  Ekakushtham  (Ichthyosis)  type  the  skin  assumes  a 
reddish  black  colour.  It  is  incurable.  In  the  form  known 
as  Charmadalam  (Hypertrophy  of  the  skin)  a  burning, 
sucking,  drawing  pain  is  experienced  in  the  palms  of  the 
hands  and  in  the  soles  of  the  feet  which  become  cha- 
racterised with  an  itching  sensation.  The  disease,  which 
affects  in  succession  the  (organic  principles  of)  skin, 
blood  and  flesh,  and  speedily  extends  all  over  the  body, 
like  Erysipelas,  and  is  attended  with  a  burning  sensation 
fVidaha),  restlessness,  suppuration  and  a  piercing  pain 
and  loss  of  consciousness  (epileptic  fits),  is  called  Visarpa 
Kushtham.  The  form  in  which  a  number  of  exuding 
pustules  gradually  extend  over  the  surface  of  the  body 
is  called  Parisarpa  Kushtham.  The  type  of  the  disease 
which  is  white  and  thin,  and  is  characterised  by  itching 
and  does  not  create  any  disturbance  (in  the  patient),  is 
called  Sidhma  (Maculae  atrophicae).  This  form  is  generally 
found  to  restrict  itself  to  the  upper  part  of  the  body. 
Vicharchika  (Psoriasis)  is  characterised  by  excessive  pain 
and  itching  and  gives  rise  to  extremely  dry  crack-like 
marks  on  the  body  [hands  and  feet].  The  same  form  of 
malady  attended  with  pain,  burning  and  itching,  and 
restricting  itself  solely  to  the  lower  extremities,  is  called 
Vipatdikat.  The  type  in  which  the  eruptions  exude  (a 
kind  of  slimy  secretion)  and  which  are  circular,  thick, 
excessively  itching,  glossy  and  black-coloured  is  called 
Kitima  (Keloid  tumours).  Small  pustules  or  pimples 
characterised  by  an  itching,  burning  secretion  and 
appearing  on  the  surface  of  the  body  are  called  Fakma 
(Eczema).       The   preceding  kinds    of  pimples   attended 


Chap,  v.]  NIDANA  STHANAM.  39 

with  burning  vesicles,  are  called  Kachchus  and  are 
found  to  be  chiefly  confined  to  the  legs,  hands  and 
buttocks.  A  sort  of  dry  and  non-exuding  pimples 
characterised  by  excessive  itching  and  appearing  all 
over  the  body,  is  called    Rakasai    (dry  Erythema).   9-10. 

The  forms  known  as  Sthularushka,  Sidhma,  Rakasa, 
Mah^kushtham  and  Ekakushtham  should  be  considered 
as  offspring  of  the  deranged  Kapham.  Parisarpa-kush- 
tham  alone  is  due  to  the  action  of  the  deranged  Vayu, 
while  the  remaining  types  (of  minor  Kushtham)  owe 
their  origin  to  the  action  of  the  deranged  Pittam.     ii. 

Kilasam  : — The  disease  known  as  Kilasam  is 
but  another  form  of  Kushtham.  It  may  be  divided  into 
three  types  according  as  it  is  brought  about  through 
the  action  of  the  deranged  Vayu,  Pittam  or  Kapham. 
The  difference  between  Kilisam  and  Kushtham  is  that 
the  former  confines  itself  only  to  theTvaka  (the  skin)and 
is  marked  by  the  absence  of  any  secretion.*  A  case  of 
Kilasam  caused  by  the  action  of  the  deranged  Vdyu  is 
circular,  vermilion-coloured  and  rough  to  the  touch.  The 
affected  part  when  rubbed  peals  off  scales  of  morbid  skin. 
A  case  of  Kilasam,  due  to  the  action  of  the  deranged 
Pittam,  is  marked  by  eruptions,  resembling  the  petals 
of  a  lotus  flower  (in  shape  and  colour),  and  are  attended 
with  an  extremely  burning  sensation.  In  the  type 
originated  through  the  action  of  the  deranged  Kapham, 
the  affected  part  (skin)  assumes  a  glossy,  white  colour, 
becomes  thick  and  is  marked  by  an  itching  sensation. 
The  form  in  which  the  eruptions  or  patches  extend  and 
become  confluent,  invading  even  the   soles   of  the   feet, 

*  A  case  of  Kushtham  has  its  primary  seat  ir\  the  blood  and  skin  (of  the 
patient),  in  which  it  lies  confined  during  the  period  of  incubation,  after 
which  it  attacks  the  skin  and  secretes  the  characteristic  secretion  of  the 
deranged  Dosha  involved  in  it* 


40  THE  SUSHRUTA  SAMHITA.  [Chap.  V. 

the  palms  of  the  hands  and  the  region  of  the  anus,  and  in 
which  the  local  hairs  assume  a  red  colour  should  be 
regarded  as  incurable.  A  case  of  Kilasham,  which  is 
the  outcome  of  a  burn  (cicatrix)  should  be  likewise  con- 
sidered as  incurable.     12. 

A  preponderance  of  the  deranged  Vayu   in  a  case  of 
Kushtham  (leprosy)  is  indicated  by  a  contraction  of  the 
skin,   local    anaesthesia,  a  copious    flow  of    perspiration, 
swelling,  and  piercing  or  cutting  pain  in  the  affected  part, 
together  with  a    deformity   of  the  limbs  and  hoarseness. 
Similarly,  an  excess  of  the  deranged  Pittam  in  a    case    of 
Kushtham,  should  be  presumed  from  the  suppuration    of 
the  affected  part,  from  the  breaking   of  the    local    skin, 
from   the    falling  off  of  the    fingers,  from    the  sinking  of 
the  nose  and  ears,  from  the  redness  of  the  eyes  and  from 
the  germination  of  parasites  in  the  incidental  ulcer.     An 
excessive  action  of  the  deranged  Kapham,  in   a   case   of 
Kushtham,  gives  rise  to  itching,  discolouring  and  swelling 
of  the   affected    part  which   becomes  heavy   and  exudes 
the  characteristic  secretion.     The  types,  Pundarika   and 
Kakanam,   which    are   due   to   the   germinal   defect    of 
the   patient,  are   incurable,    inasmuch   as    they  involve 
(according   to     Dallana)     the   concerted  action   of   the 
three     simultaneously    deranged   Doshas  from  the  very 
outset.     1 3 . 

Memorial  verses  :-~As  a  tree,  full  grown  in  the 
course  of  time,  has  driven  its  roots,  which  derive  their 
nourishment  from  the  rain  water,  deeper  and  deeper 
into  the  successive  strata  of  the  soil,  so  this  disease 
(Kushtham),  first  affecting  and  confining  itself  to  the 
upper  layers  of  the  skin,  will  invade  the  deeper  tissues 
and  organs  etc.  of  the  patient,  if  unchecked  until  al- 
most all  the  fundamental  principles  or  elements  Dhdtus 
are  attacked  by  its  virus  in  the  course  of  time.     14. 


Chap,  v.]  NibANA  STHANAM.  4t 

The  symptoms  of  a  case  of  Kushtham  confined  only 
to  the  serous  (Tvaka)  fluid  of  the  skin  are  the  loss  of  the 
perception  of  touch,  a  scanty  perspiration,  itching  and  dis- 
coloration and  roughness  of  the  affected  part.  The  symp- 
toms which  manifest  themselves  when  the  disease  is  con- 
fined to  the  blood  are  complete  anaesthesia,  horripilation, 
absence  of  perspiration,  itching  and  excessive  accumu- 
lation of  pus  in  the  affected  parts.  The  symptoms  of 
Kushtham  affecting  only  the  flesh  are  thickness  of  the 
patches,  dryness  of  the  mouth,  roughness  and  hardness 
of  the  patches  which  become  covered  with  pustular 
eruptions  and  vesicles,  and  an  excruciating  pricking  pain 
in,  and  numbness  of,  the  affected  part.  The  symptoms 
of  (Kushtham)  invading  the  principle  of  fat  only  are  a 
fetid  smell  and  an  excessive  accumulation  of  pus  in  the 
affected  part  and  a  breaking  of  the  skin,  exposing  deep 
gashing  wounds  which  soon  become  infested  with  para- 
sites. The  body  seems  as  if  covered  with  a  plaster. 
Symptoms  of  (Kushtham)  affecting  only  the  bones  and 
the  marrow  are  a  sinking  (lit:  breaking)  of  the  nose,  a 
redness  of  the  eyes,  loss  of  voice  and  the  germination 
of  parasites  in  the  incidental  ulcers.  Symptoms  of  the 
disease  restricting  itself  only  to  the  principle  of  semen 
are  a  crippled  state  of  the  hands  and  distortion  of  the 
limbs,  loss  of  the  power  of  locomotion,  spreading  of 
ulcers  and  all  the  other  symptoms  peculiar  to  the  pre- 
ceding types  of  the  disease.     15  —  20. 

A  child,  which  is  the  offspring  of  the  contaminated 
semen  and  ovum  of  its  parents  afflicted  with  Kushtham, 
should    be    likewise    regarded    as    a    Kushthi.     21. 

Prognosis: — A  case  of  Kushtham  appearing 
in  a  person  of  prudence  and  discretion  and  confined 
only  to  the  serum  (Tvaka),  flesh  and  blood  of  his  orga- 
nism should  be  regarded  as  curable.    A  palliative  treat- 

6 


42  THE   SUSHRUTA    SAMHlTA.  [Chap.  V. 

ment  is  the  only  remedy  in  cases  where  the  disease  is 
found  to  invade  the  principle  of  fat  ;  whereas  a  case 
where  the  poison  is  found  to  have  penetrated  into 
any  of  the  remaining  organic  principles  should  be  given 
up  as  incurable.     22, 

Wise  men  hold  that,  for  killing  a  Brahmana,  or  a  wo- 
man, or  one  of  his  own  relations,  for  theft,  as  well  as  for 
doing  acts  of  impiety,  a  man  is  sometimes  cursed  with 
this  foul  disease  by  way  of  divine  retribution.  The  disease 
reattacks  a  man  even  in  his  next  rebirth  in  the  event  of 
his  dying  with  it.  Uncured  Kushtham  (leprosy)  is  the 
most  painful,  and  most  troublesome  of  all  diseases.  23 — 24. 

A  Kushthi  (leper),  getting  rid  of  this  foul  malady  by 
observing  the  proper  regimen  of  diet  and  conduct  and 
by  practising  expiatory  penances  and  by  resorting  to 
proper  medicinal  measures,  gets  an  elevated  status  after 
death.     25. 

Kushtham  (Leprosy)  is  a  highly  contagious  disease  ; 
the  contagion  being  usually  communicated  through 
sexual  intercourse  with  a  leper  (Kushthi),  or  by  his  touch 
or  breath,  or  through  partaking  of  the  same  bed,  and 
eating  and  drinking  out  of  the  same  vessel  with  him,  or 
through  using  the  wearing  apparel,  unguents  and 
garlands  of  flowers  previously  used  by  a  person  afflicted 
with  this  dreadful  disease.  Kushtham  (Leprosy),  fever, 
pulmonaiy  consumption,  ophthalmia  and  other  Aupasar- 
gika  disease  (incidental  to  the  influences  of  malignant 
planets  or  due  to  the  effects  of  impious  deeds)  are 
communicated  from  one  person  to  another.     26. 

Thus   ends  the   fifih  Chipter   of  the    Nidanaslhanam    in  the  Sushruta 
Samhila  which  treats  of  the  Nidanam  of  cutaneous  affections  (Kushtham). 


CHAPTEE  VI. 

Now  we  shall  discourse  on  the  Nidanam  of  Pra- 
meha  (diseases  of  the  urinary  tracts),    i. 

It  may  be  prognosticated  that  an  idle  man,  who 
indulges  in  day  sleep,  or  follows  sedentary  pursuits  or 
is  in  the  habit  of  taking  sweet  liquids,  or  cold  and 
fat-making  or  emollient  food,  will  ere  long  fall  an  easy 
victim  to  this  disease.     2. 

Pathology  : —The  bodily  principles  of  Vdyu, 
Pittam  and  Kaphah  of  such  a  person  get  mixed  with 
improperly  formed  chyle  of  the  organism.  Thus  deranged, 
they  carry  down  through  the  urinary  ducts  the  de- 
ranged fat,  etc.*  of  the  body  and  find  lodgment  at  the 
mouth  (neck)  of  the  bladder,  whence  they  are  emitted 
through  the  urethra -t",  causing  diseases,  known  by  the 
(generic)  name  of  Prameha.   3 

Premonitory  symptoms: -A  burning 
sensation  in  the  palms  of  the  hands  and  of  the  soles  of 
the  feet,  a  heaviness  of  the  body,  coldness  or  sliminess 
of  the  skin  and  limbs,  sweetness  and  whiteness  of 
the  urine,  somnolence,  lassitude,  thirst,  a  bad-smelling 
breath,  a  shortness  of  breath,  slimy  mucous  deposit  on  the 
tongue,  palate,  pharyx  and  teeth,  clotted  hair  and  an  in- 
ordinate growth  of  the  finger  and  toe  nails  are  the 
indications  which  mark  the  advent  of  the  disease.     4. 

General  Characteristics:— A  copious  flow 

of  cloudy  or  turbid  urine  characterises  all  the  types  of 
the  disease,  which,  together  with  the  abscesses  and 
eruptions  (Pidaka)    which    mark   its    sequel,  should  be 

*  The    particle    "cha"    in    the   text  denotes  other    virus   or    morbific 
matter.     Dallana. 

t  Remain  incarcerated  therein  according  to  others. 


44  THE   SUSHRUTA   SAMHITA.  [Chap.  VI. 

regarded  as  involving  the  concerted  action  of  the  de- 
ranged Doshas  (Vayu,  Pittam  and  Kaphah).     5. 

The  Kaphaja  Types  : —Cases  of  Prameha, 
which  are  caused  by  an  exuberance  of  the  deranged 
Kapham,  may  be  grouped  under  ten  subheads  such  as, 
Udaka-meha,  Ikshu-meha,  Sura-meJia,  Sikata-meha,  S'a- 
nai-meha,  Lavana-meha,  Pishta-meha,  Scindra-meha,  S'uk- 
ra-meha  and  Phena-meha.  The  ten  aforesaid  types  are 
curable,  inasmuch  as  the  medicines  which  tend  to  remedy 
the  deranged  Kapham  (Dosha),  the  cause  of  the  disease, 
prove  also  remedial  to  the  other  principles  of  the  body 
(flesh,  marrow,  blood,  semen  etc.)  deranged  (Dushya) 
from  the  same  causes.     6. 

The  Pittaja  Types  :  — The  types,  which  are 
brought  about  through  an  exuberance  of  the  deranged 
Pittam,  are  named  as  Nila-meha,  Haridrd-meha,  Amla- 
meha,  KsJiara-meha,  ManjisJitha-ineha^  and  S'onita-meha, 
Palliation  is  all  that  can  be  effected  in  these  types, 
inasmuch  as  the  medicines  which  tend  to  correct  the  de- 
ranged Pittam,  which  has  brought  on  the  disease,  fail 
to  exert  similar  virtues  on  the  organic  principles 
(Dushyas)  deranged  by  it.     7. 

The  Vataja  Types  :— The  types  of  Prameha 
which  are  produced  by  an  aggravated  condition  of 
the  bodily  Vayu  are  divided  into  four  subgroups,  such  as 
Sarpi-ineha,  Vasd-meha,  Kshoudra-meha  and  Hasti-ineha. 
These  should  be  regarded  as  most  incurable  inasmuch  as 
no  kind  of  medicine  can  restore  the  fleet-coursing,  deep 
diving  {ie.  invading  the  bones  and  the  marrow)  Vayu, 
which  at  the  same  time  also  augments  the  Pittam,  to  its 
normal  state  and  thus  advances  (unchecked)  in  its  work 
of  disintegration.     8. 

The  deranged  Kaphah,  in  conjunction  with  the 
(morbid)  Pittam,  Vayu  and  fat,  gives  rise  to  all  Kaphaja 


Chap.  VI.  NIDANA   STHANAM.  45 

types  of  Prameha.  The  deranged  Pittam,  in  conjunc- 
tion with  the  deranged  Vayu,  blood,  fat  and  Kapham, 
produces  the  Pittaja  ones  ;  while  the  deranged  Vayu,  in 
unison  with  the  deranged  Kapham,  Pittam,  fat,  marrow 
and  Vasa  (myosin),  engenders  the  types  of  Vataja 
Prameha.     9. 

Symptoms  of    Kaphaja  IVIehas  : -The 

urine*  of  a  person  suffering  from  an  attack  of  Udaka- 
meha  becomes  white  and  water-like  and  is  passed  without 
the  least  pain.  In  a  case  of  Ikshumeha  the  urine 
resembles  the  expressed  juice  of  sugarcane.  It  has  the 
colour  of  wine  in  a  case  of  Surameha.  The  urine  in  a 
case  of  Sikatameha  is  passed  with  pain  and  is  found 
to  leave  a  sediment  of  extremely  fine  and  sand-like 
concretions  {Sikatas).  In  a  case  of  Sanaimeha  the 
urine  gushes  out  at  intervals  in  jets  and  is  charged 
with  a  slimy  mucous  (kaphah).  The  urine  in  a  case  of 
Lavauameha  becomes  limpid  (non-viscid)  and  acquires 
a  saline  taste.  There  is  horripilation  at  the  time  of 
micturition  in  a  case  of  Pishtameha  (Chyluria),  the 
urine  resembling  a  stream  of  water,  charged  with  a 
solution  of  pasted  rice   (Pishtam). 

In  a  case  of  Sandrameha,  the  urine  becomes 
thick  and  turbid,  while  in  a  case  of  Sukrameha 
the  urine  resembles  semen  (or  the  urine  is  found  to 
be     charged   with   semen  : — Madhaba).     In    a    case   of 


*  Tl  e  Sanskrit  term  Meha  literally  means  to  micturate.  The  verbal 
noun  Mehanam  signifies  utination  as  well  as  the  act  of  passing  any  morbid 
urethral  secretion.  Hence  the  urine  in  most  of  these  cases  denotes  the 
fact  of  its  being  charged  with  pus  or  any  other  morbid  secretion  of  the 
urinary  oigans  such  as  Ojah  (albumen),  marrow,  etc.,  which  imparts  tluir 
characteristic  colours  to  the  fluid, —a  fact  which  determines  the  nomen- 
clature of  the  disease  and  forms  the  keynote  of  its  diagnosis  in  the 
Ayurveda.— Ed. 


46  THE  SUSHRUTA   SAMHITA.  [Chap.      I. 

Phenamelia  the  patient  passes  frothy  urine  in  broken 
jets.     lo. 

Symptoms  of  Pittaja  Mehas :— Now  we 

shall  describe  the  characteristic  features  of  the  types 
of  Prameha,  which  are  due  to  the  action  of  the  deranged 
Pittam.  The  urine  in  a  case  of  Nilameha  becomes 
frothy,  transparent  and  bluish.  The  urine  in  a  case  of 
Haridrameha  becomes  deep  yellow  like  turmeric 
(Haridra)  and  is  passed  with  a  burning  pain.  The 
urine  in  a  case  of  Amlameha  acquires  an  acid  taste  and 
smell.  The  urine  in  a  case  of  Kshairameha*  resembles 
an  alkaline  solution  filtered  (through  a  piece  of  linen). 
The  urine  in  a  case  of  MaDJisthameha  resembles  the 
washing  of  the  Manjistha,  while  in  a  case  of  Raktameha, 
the  urine  is  found  to  be  of  blood-colour  ^or  charged  with 
blood  -  Madhava).     1 1 . 

Symptoms  of  Vataja-IVIehas  :— Now  we 

shall  describe  the  characteristics  of  the  different  types  of 
Prameha,  which  are  due  to  an  exuberance  of  the 
deranged  Vayu.  In  a  case  of  Sarpimeha,  the  urine 
looks  like  a  stream  of  clarified  butter,  while  in  one  of 
Vasatmeha  it  resembles  the  washings  of  Vasa.  In  a  case 
of  Kshaudrameha,  the  urine  looks  like  honey  and 
acquires  a  sweet  taste.  In  one  of  Hastimsha,  the 
patient  passes  a  copious  quantity  of  urine,  like  an 
excited  elephant,  at  a  time,  and  in  one  unbroken  stream, 
(the  organ  becoming  steady  immediately  after  the  act 
of  micturition).     I2. 

Supervening"  symptoms  :— The   fact   of 

the  urine  being  assailed  by  a  swarm  of  flies,  lassitude, 
growth  of  flesh  (obesity),  catarrh,  looseness  of  the  limbs,  a 

*    The  urine  acquires  a  distinct  alkaline  taste,  smell,  colour  and  touch. 
(Madhaba  Nidanam). 

f  Charaka  has  included  it  within  Kshaudra  Meha  and  Madhu  Me  a. 


Chap.  VI.]  NIDANA   STHANAM.  47 

non-relish  for  food,  Indigestion,  expectoration  of  mucous, 
vomiting,  excessive  sleep,  cough  and  laboured  breathing 
(Svasa)  are  the  supervening  traits  (Upadrava)  of  the 
Kaphaja  Prameha.  A  piercing  pain  in  the  testes,  a 
pricking  (veda)  pain  in  the  bladder,  a  shooting  pain 
(Tuda)  in  the  penis,  a  griping  pain  at  the  heart,  acid 
eructations,  fever,  dysentery,  a  non-relish  for  food, 
vomiting,  a  sensation  as  if  the  entire  body  is  emitting 
fumes,  a  burning  sensation  in  the  skin,  thirst, 
epileptic  fits,  insomnia,  jaundice  (Pandu)  and  a  yellow 
colour  of  the  stool  and  urine  are  the  supervening 
symptoms  which  mark  the  Pittaja  types  of  Prameha. 
An  oppressive  feeling  at  the  heart  (Hridgraha),  eager 
longings  for  foods  of  all  tastes,  insomnia,  numbness 
of  the  body,  fits  of  shivering,  colic  pain  and  constipation 
of  the  bowels  are  the  supervening  symptoms,  which 
specifically  mark  the  Vataja  types.  Thus  we  have 
described  the  nature  of  the  twenty  different  types  of 
Meha  with  their  supervening  evils  as  well.     13-16. 

The  ten  different  types  of  Pidaka  (abscess,  carbun- 
cles, pimples,  pustules  etc.)  are  found  to  crop  up  on  the 
bodies  of  patients, suffering  from  Prameha,  and  abounding 
in  fat  and  Vasa,  and  whose  fundamental  principles  have 
been  affected  by  the  simultaneous  derangement  of 
the  Vayu,  Pittam  and  Kapham.  They  are  named  as 
Siravikat,  Sarshapika,  Kachchapika;  Jaiini,  Vinat^, 
Putrini,  Masurika,  Alaji,  Vids^rika  and  Vidradhikab.  \7 - 

IVIctrical  Texts  : — An  abscess  which  is  raised 
at  the  margin  and  dipped  in  its  centre,  so  as  to  resemble 
an  Indian  saucer  in  its  shape  is  called  Saravik^.  Pimp- 
les or  pustules  of  the  shape  and  size  of  white  mustard 
seeds  are  called  Sarshapikat.  An  abscess,  resembling 
(the  back  of)  a  tortoise  in  shape  and  attended  with  a 
burning   sensation,   is    called  Kachchapika  by  the  wise. 


48  THE  SUSHRUTA   SAMHITA.  [C^i^P-  ^^» 

An  abscess  studded  with  slender  vegetations  of  flesh  and 
attended  with  an  intolerable  burning  sensation  is  called 
Jg^lini.  A  large  blue-coloured  abscess  (carbuncle) 
appearing  on  the  back  or  the  abdomen,  and  exuding  a 
slimy  secretion  and  attended  with  a  deep-seated  pain  is 
called  Vinatat  A  thin  and  extensive  abscess  (studded 
withslender  pustules —D.R.)  is  called  Putrini.  Pimples  to 
the  size  of  lentil  seeds  are  called  Masurika.  A  dreadful 
abscess  which  is  of  a  red  and  white  colour,  studded  over 
with  blisters  or  exuding  vesicles  is  called  Alaji.  A  hard 
and  round  abscess  as  large  as  a  (full-grown)  gourd  is 
called  Vidai'ikat.  An  abscess  of  the  Vidradhi  type  is 
called  Vidradhika (carbuncle) by  the  wise.  An  incidental 
abscess  in  a  case  of  Prameha  should  be  regarded  as 
having  its  origin  in  the  same  morbific  principle  (Dosha) 
as  that  which  has  produced  the  disease  (Prameha)  18-28. 

Prognosis  : — A  Pidaka,or  an  abscess, appearing 
about  the  region  of  the  heart,  anus,  head,  shoulder,  back 
or  at  any  of  the  vital  joints  (Marma)  of  the  body,  and 
attended  with  other  supervening  symptoms  producing 
extreme  prostration  [impaired  digestion — D."  R.]  in 
the  patient  should  be  abandoned  as  incurable.  In 
a  case  of  Vataja  meha,  the  deranged  Vayu  presses 
all  the  fundamental  principles  out  of  the  body  through 
the  urethra  and  rages  rampant  in  the  lower  part  of  the 
body,  united  with  the  deranged  fat,  marrow  and  Vasa. 
Hence  a  case  of  Vataja  meha,  (or  its  accompanying 
abscess),  is  held  as  incurable.     29-30. 

A  person  in  whom  the  premonitory  symptoms  (Pur- 
varupam  of  Prameha)  have  appeared  and  who  passes 
a  little  larger  quantity  of  urine  than  usual,  should  be 
considered  as  already  afflicted  with  it.  A  person 
afflicted  with  all  or  half  of  the  premonitory  symptoms 
of  the   disease    and  passing  a  copious  quantity    of  urine 


Chap.  VI.  NIDANA  STHANAM. 


49 


should   be  considered    as   one   suffering  from  an  attack 
ofPrameha.     31 — 32. 

A  Prameha  patient  afflicted  with  deep-seated  absces- 
ses and  other  distressing  symptoms,  which  are  usually 
found  to  supervene  in  the  disease,  should  be  pronounc- 
ed as  suffering  from  Madhumeha  and  adjudged  incurable. 
A  Madhumeha  patient  seeks  a  halting  place  while  walk- 
ing, wants  a  place  to  sit  on  while  halting,  lies  down  if  he 
finds  a  sitting  place,  and  sleeps  if  he  lies  down.     33 — 34. 

As  five  mixed  colours  such  as  grey,  brown,  Kapila 
(bluish  yellow),  Kapota  (blackish  grey),  Mechaka 
(light-green)  may  be  produced  by  combination  of  the 
five  primary  colours  in  definite  proportions  (such  as 
white,  green,  black,  yellow  and  red),  so  a  diversity  of 
causes,  through  the  relative  preponderance  of  the  parti- 
cular kinds  of  food,  and  of  the  deranged  Doshas,  root 
principles  (Dhatu)  and  excretions  of  the  body  (Mala), 
may  be  attributed  to  the  origin  of  Prameha.     35. 

IVIemorial  verses  :— All  types  of  Prameha, 
not  properly  treated  and  attended  to  at  the  outset, 
may  ultimately  develop  into  those  of  Madhumeha 
types,  which  are  incurable.     36 

For  English  equivalents  of  the  different  types  of  Prameha  compare  :  — 
Cystitis  (Acute  Infective) — Frequent,  painful  micturition,  small  quantity 
of  urine  voided  with  pain  and  urgency.  Urine — slightly  acid  or  alkaline  in 
reaction,  cloudy,  containing  blood  corpuscles.  Cystitis  (Chronic  Infective) 
— Great  and  frequent  pain,  in  the  lumbar  region,  rigor.  Urine — thick, 
offensive  and  alkaline,  containing  ropy  mucous  and  blood.  Cystitis  (Non- 
Infective) — Symptoms  like  those  of  acute  inflammatory  type.  Urine- 
acid  and  cloudy  with  mucous.  Blood  is  generally  present  in 
considerable  quantity.  Neuralgia  of  the  bladder,  compare  Albuminuria, 
Albumosuria,  Hoemoglobinuria,  Hoematuria,  Peptonuria,  Pyuria, 
Spermatorrhoea  and  Diabetes,  Proteuria  and  Polyuria. 

Thus   ends   the   sixth  Chapter  of  the  Nidana  Sthanam  in  the  Sushruta 
Samhit^,  which  treats  of  the  Nidanam  of  Prameha. 


QS 


CHAPTER  YII. 

Now  we  shall  discourse  on  the  Nidainam  of  Udara 

(dropsy  with  an  abnormal  condition  of  the  abdomen),    i. 

Metrical  Text  :— The  royal  sage  Dhanvan- 
tari,  the  foremost  of  all  pious  men  who  equalled 
in  splendour  and  glory  the  lord  of  the  celestials,  thus 
blissfully  discoursed  on  the  Niddnam  of  Udara  to 
Susruta,  the  son  of  the  holy  Vis'vamitra,  who  devoutly 
approached  him  for  that  purpose.     2. 

Classification  : — This  disease  may  be  divided 
into  eight  different  types,  of  which  four  are  produced 
by  the  several  actions  of  the  three  deranged  Doshas  of 
the  body  and  their  concerted  action  as  well.  Of  the  re- 
maining types,  two  being  known  as  Plihodara  (including 
Yakritodara),  and  Vaddha-Gudodara  (tympanites  due  to 
the  constriction  of  the  anus),  the  seventh  Agantuka 
(traumatic  or  of  extraneous  origin),  and  the  eighth 
Dakodara  (Ascites  proper).     3. 

Predisposing     Causes :— The     deranged 

Doshas  of  a  person  of  extremely  impaired  digestion, 
addicted  to  the  habit  of  taking  unwholesome  food,  or 
of  eating  dry,  putrid  food,  or  of  violating  the  rules  of 
conduct  to  be  observed  in  connection  with  oleaginous 
measures  etc.,*  are  aggravated  and  find  lodgment  in  the 
abdomen.  Thus  appearing  in  the  shape  of  an  abdomi- 
nal tumour  (Gulma),  they  give  rise  to  this  dreadful  disease, 
attended  with  all  its  characteristic  symptoms.  The  lymph 
chyle  formed  out  of  the  assimilated  food  getj  vitiated, 
and,   impelled    by   the   aggravated    Vdyu,   it   percolates 

*  These   include   purgative,    erpitic,    A'stha'panam   and  Anuva'sapann 
p(iej^su|re§, 


k 


th«p.  VII.]  NIDANA   STHANAM.  Jt 

through  the  peritoneum  in  the  same  manner  as  a  quantity 
of  oil  or  clarified  butter  kept  in.  a  new,  earthen  pot  will 
transude  through  the  pores  of  its  sides.  It  thus  gradually 
distends  the  skin  (Tvak)  of  the  abdomen.  The  process 
becomes  general  all  through  the  abdominal  region  and 
the  disease  (Udara)  is  produced  in  consequence.    4 — 5. 

Premonitory  sypmtoms  :— The  precursory 

symptoms  of  the  disease  are  loss  of  strength,  complexion 
and  appetite,  emaciation  of  the  muscles  of  the  abdomen, 
appearance  of  veins  on  its  surface,  acid  reaction  of  food 
closely  following  upon  its  digestion  (Viddha\  pain 
in  the  bladder,  and  swelling  of  the  lower  extremities. 
The  patient  cannot  ascertain  whether  his  meal  has  been 
digested  or  not.    6. 

The   Vataja,   Pittaja,    and    Kaphaja 

Types  : — A  case  of  Udara  in  which  the  abdomen  en- 
larges on  its  sides  and  posterior  part,  and  is  over- 
spread with  nets  of  black  veins  should  be  ascribed  to  the 
action  of  the  deranged  Vdyu.  A  pain  (Sula),  suppression 
of  the  stool  and  urine  (Andha)  and  a  cutting  and  piercing 
pain  and  flatulent  rumbling  in  the  intestines  are  the  symp- 
toms which  likewise  characterise  this  Va'taja  form  of 
Udara.  A  sucking  pain  in  the  abdomen,  thirst,  fever  with 
a  burning  sensation,  yellow  colour  of  the  swollen  skin  of 
the  abdomen,  on  the  surface  of  which  yellow  veins 
appear,  yellow  colour  of  the  eyes,  nails,  face,  stool  and 
urine  and  the  rapid  increase  of  the  dropsical  swelling,  are 
the  characteristics  of  the  Pittaja  Udara.  In  a  case  of 
Kaphaja  type  the  dropsical  swelling  is  cold  to  the  touch 
and  becomes  overspread  with  white-coloured,  veins. 
The  abdomen  seems  heavy ,  hard,  glossy  and  is  extreme- 
ly distended.  The  swelling  slowly  increases,  and  the  finger- 
nails and  face  of  the  patient  become  white,  and  he 
complains  of  a  general  lassitude.  7 — 9. 


52  THE  SUSHRDTA  SAMHITA.  tChap.  VIl. 

The  TridOShaja   Type  :— Evil-natured   wo- 
men (with  a  view  to  win  the  affections  of  their  husbands 
or  lovers  sometimes)  mix  with  their  food  and  drink  such 
refuse  matters  of  their  bodies  as  nails,  hair,  faeces,     urine, 
catamenial  blood  etc.  (which  are  supposed  to  be  possessed 
of  talismanic  virtues).  The  three  Doshas  of  the  body,  vitia- 
ted by  such  food  or  drink,  or  through  imbibing  any  sort  of 
chemical  poison  (Gara)  administered  by  one's  enemy,  or 
by  taking  poisonous  waters,  or  Dushi-Visha  (slow  poison 
whose  active  properties  have  been    destroyed  by   fire   or 
any   antipoisonous    medicine),  will  vitiate  the  blood  and 
give  rise  to  a  kind  of  dreadful  dropsical  swelling   of  the 
abdomen,  marked    by   the    specific   symptoms    of    each 
of  them      The  disease  is  aggravated  in  cold  and  cloudy 
days  and  a  burning  sensation  is    felt   (in    the    inside   of 
the   abdomen\     The    patient   becomes  pale,  yellow   and 
emaciated,   and  is  afflicted  with  thirst  and  dryness  in  the 
mouth,  and  loses   consciousness    at  short  intervals.  This 
disease  is  also  known  as  the  dreadful  Dushyodaram.  lo. 
Plihodaram. — (Spleen  with  dropsy  of  the  abdo- 
men) : — -Now  hear  me  describe  the  symptoms   of  Pliho- 
daram. The   blood  and  the  Kapham  of  a  person,  derang- 
ed and  aggravated    through   the  ingestion    of    phlegma- 
gogic   food,    or   of  those   which  is  followed  by   an  acid 
digestionary  reaction  (Viddha),  often  enlarge  the  spleen, 
(which  gives  rise  to  a  swelling  of  the   abdomen).     This 
disease  is  called  Plihodara  by  the  experts.     Plihodaram 
protrudes  on  theleft  sideof  the  abdomen,  its  characteristic 
symptoms  being  lassitude,  low  fever,  impaired  digestion, 
loss  of  strength,  jaundice,  weakness,  and  other  distress- 
ing   symptoms   peculiar   to   the   deranged   Pittam   and 
Kapham.     A  similar  enlargement  of  the   liver   through 
similar   causes  on   the  right   side   of  the   abdomen   is 
called  Jakriddfitly udarani.   1 1 — 1 2. 


Chap.  Vll.]  NIDANA  SfHAJSTAM.  ^3 

Vaddha-gUdOdaram*  :— The  fecal  matter, 
mixed  with  the  deranged  Vayu,  Pittam  etc.  of  the 
body,  lies  stuffed  in  the  rectum  of  a  person  whose  in- 
testines have  been  stuffed  with  slimy  food  (as  pot  herbs) 
or  with  stones  and  hair  (enteritis).  They  give  rise  to 
a  sort  of  abdominal  dropsy  by  swelling  the  part  between 
the  heart  and  the  umbilicus  which  is  called  Vaddha 
Gudodaram.  Scanty  stools  are  evacuated  with  the  great- 
est pain  and  difficulty  and  the  patient  vomits  a  pe- 
culiar kind  of  matter  with  a  distinctly  fecal  smell 
(scyabalous  ?).    13. 

Parisravi-Udaram  :  — Now  hear  me  describe 
the  causes  and  symptoms  of  the  type  of  Udaram  which 
is  called  Parisratvi-udaram.  Thorny  or  sharp-pointed 
substances  (such  as  fish-bones  etc.),  carried  down  with 
the  food  in  a  slanting  way  from  the  stomach  into  the 
abdomen,  sometimes  scratch  or  burrow  into  the  intes- 
tines. Causes  other  than  the  preceding  ones,  (such  as 
a  long  yawn  or  over-eating  etc.)  may  contribute  to  the 
perforation  of  the  intestines,  giving  rise  to  a  copious 
flow  of  a  watery  exudation  which  constantly  oozes  out 
of  the  anus  and  to  a  distension  of  the  lower  part  of  the 
abdomen  situated  below  the ,  umbilicus.  This  is  called 
Parisravy udaram  which  is  marked  by  a  cutting  pain  and 
a  burning  sensation.     14. 

Dakodaram  :  — Now  hear  me  describe  the 
causes  and  symptoms  of  the  type  known  as  Dakodaram 
(ascites).  The  drinking  of  cold  water  immediately  after 
the  application  of  an  Aunvdsanam  or  Asthapanam 
enema,  or  closely  following  upon  the  exhibition  of  any 
purgative  or  emetic  medicine,  or  just  after  the  taking  of 
a    medicated  oil  or  clarified  butter,  etc.  tends  to  derange 

*  Dropsical  swelling  of  the  abdomen  with  tympanites  due  to  the   cons- 
triction of  the  rectum  known  as  intestinal  obstruction. 


54  THE  SUSHRUTA   SAMHITA.     '       [Chap.  VII. 

the  water-carrying  channels  of  the  body.  The  same  result 
may  be  produced  by  the  drinkmg  of  oil,  etc.  in  inordi- 
nate quantities  The  water,  by  percolating  or  transud- 
ing through  the  walls  of  these  channels,  as  before  des- 
cribed, inordinately  enlarges  the  abdomen,  which  be- 
comes glossy  on  the  surface  and  is  full  of  water,  being 
rounded  about  the  umbilicus  and  raised  like  a  full- 
bloated  water-drum.  The  simile  is  complete  as  it 
fluctuates  under  pressure,  oscillates,  and  makes  a  pecu- 
liar sound  like  a  water-drum  under  percussion.     15. 

Distension  of  the  stomach,  incapacity  of  locomotion, 
weakness,  impaired  digestion,  cedematous  swelling  of 
the  limbs,  a  general  sense  of  lassitude  and  looseness  in 
the  limbs,  suppression  of  flatus  and  stool,  and  a  burning 
sensation  and  thirst  are  among  the  general  characteris- 
tics of  the  disease  in  its  various  forms.     16. 

Prognosis  : — All  cases  of  Udaram  after  the 
lapse  of  considerable  time  develop  into  those  of  ascites, 
and  a  case  arriving  at  such  a  stage  should  be  given  up  as 
incurable.     16 — 17. 

Thus  ends  the  seventh  Chapter  of  the  Nidana  Slhanam  in  the  Sub'ruta 
Samhita  which  treats  of  the  Nidanam  of  Udaram. 


CHAPTER  Vm. 

Now  we  shall  discourse  on  the  Nidanam  of 
IVlUClhagarbham  (false  presentations  and  difficult 
labour),  i. 

Causes   of    lYIudha-garbham  : -Sexual 

intercourse  during  pregnancy,  riding  on  horseback,  etc., 
or  in  any  sort  of  conveyance,  a  long  walk,  a  false  step,  a 
fall,  pressure  on  the  womb,  running,  a  blow,  sitting  or 
lying  down  on  an  uneven  ground,  or  in  an  uneven 
posture,  fasting,  voluntary  repression  of  any  natural 
urging  of  the  body,  partaking  of  extremely  bitter, 
pungent,  parchifying  articles,  eating  in  inordinate  quan- 
tities of  Sakas  and  alkaline  substances,  dysentery 
(Atisdra),  use  of  emetics  or  purgatives,  swinging  in  a 
swing  or  hammock,  indigestion,  and  use  of  medicines 
which  induce  the  labour  pain  or  bring  about  abortions, 
and  such  like  causes  tend  to  expel  the  faetus  from  its 
fixture.  These  causes  tend  to  sever  the  child  from  the 
uterine  wall  with  its  placental  attachment  owing  to  a 
kind  of  Abhighatam  (uterine  contraction)  just  as  a  blow 
tends  to  sever  a  fruit  from  its  pedicel.     2. 

Definition:— The  faetus,  thus  severed  and 
dislodged  from  its  seat,  excites  peristalsis  not  only  in 
the  uterus,  but  induces  a  sort  of  constant,  spasmodic 
contraction  of  the  intestinal  cavities  (Koshthas),  pro- 
ducing pain  in  the  liver,  spleen,  etc.  The  Apana  Vayu, 
thus  obstructed  through  the  spasmodic  contraction 
of  her  abdomen,  produces  any  of  the  following  symp- 
toms, viz.  a  sort  of  spasmodic  pain  in  the  sides,  or 
in  the  neck  of  the  bladder,  or  in  the  pelvic  cavity, 
or  in  the  abdomen,  or  in  the  vagina,  or  Andha  (tymp- 
anites    with     obstruction,    etc,)    or   retention    of  urine, 


^6  THE  SUSHRUTA  SAMHITA.  tChap.  VIII. 

and  destroys  the  faetus,  if  immature,  attended  with 
bleeding.  In  case  the  faetus  continues  to  develop 
and  is  brought  in  an  inverted  posture  at  the  entrance 
to  the  vaginal  canal,  and  is  impacted  at  that  place, 
or  if  the  Apana  Vdyu  gets  disordered  and  conse- 
quently cannot  help  the  expulsion  of  the  same,  such 
an  obstructed  faetus  is  called  Mudhagarbhah.  3. 
Classification  and  Symptoms: -Cases 

of  Mudha-garbha  may  be  roughly  divided  into  four 
different  classes  such  as,  the  Kilah,  the  Pratikhurah, 
the  Vijakah  and  the  Parighah.  The  sort  of  false 
presentation  in  which  the  child  comes  with  its  hands, 
legs  and  head  turned  upward  and  with  its  back  firmly 
obstructed  at  the  entrance  to  the  vagina,  like  a  stake 
or  a  kila,  is  called  Kilah.  The  sort  of  presentation,  in 
which  the  hands,  feet  and  head  of  the  child  come 
out,  with  its  body  impacted  at  the  entrance  to  the 
vagina,  is  called  Prathikhurah.  The  type  in  which  only 
a  single  hand  and  the  head  of  the  child  come  out 
(with  the  rest  of  its  body  obstructed  at  the  same 
place),  is  called  the  Vijakah.  The  type  in  which  the 
child  remains  obstructing  the  head  of  the  passage  in 
a  horizontal  position,  like  a  bolt,  is  called  the  Parighah. 
Certain  authorities  aver  that,  these  are  the  only  four 
kinds  of  Mudhagarbha.  But  we  can  not  subscribe  to 
the  opinion  (which  recognises  only  four  kinds  of  false 
presentations),  inasmuch  as  the  deranged  Vayu  (Apana) 
can  present  the  fsetus  in  various  different  postures 
at  the  head  of  the  vaginal  canal.  Sometimes,  the  two 
thighs  of  the  child  are  first  presented,  and  sometimes  it 
comes  with  a  single  leg  flexed  up.  Sometimes  the 
child  comes  with  its  body,  bent  double,  and  thighs 
drawn  up,  so  that  only  breech  is  obliquely  presented. 
Sometimes   the    child  is  presepted,  impacted  at  the  head 


Chap.  VIII.]  NIDANA   STHANAM.  57 

of  the  passage  with  its  chest,  or  sides,  or  back.  Some- 
times the  child  is  presented  with  its  arm  around  its  head, 
resting  on  the  side,  and  the  hand  coming  out  first. 
Sometimes  only  the  two  hands  are  first  presented,  the 
head  leaning  on  one  side;  sometimes  the  two  hands,  legs 
and  the  head  of  the  child,  the  rest  of  the  body  being 
impacted  at  the  exit  in  a  doubled  up  posture.  Some- 
times one  leg  is  presented,  the  other  thigh  being  impacted 
at  the  passage  (Payu).  I  have  briefly  described  these 
eight  sorts  of  presentation  of  which  the  last  two 
are  irremediable.  The  rest  should  be  given  up  as 
hopeless  if  these  are  attended  with  the  following  compli- 
cations viz.,  deranged  sense-perception  of  the  mother, 
convulsions,  displacement  or  contraction  of  the  repro- 
ductive organ  (yoni)  a  peculiar  pain  like  the  after-pain  of 
child  birth,  cough,  difficult  respiration,  or  vertigo.  4. 

lYIemorial  verses  :— As  a  fruit,  fully  matured, 
is  naturally  severed  from  its  pedicel  and  falls  to  the 
ground  and  not  otherwise,  so  the  cord,  which  binds 
the  foetus  to  its  maternal  part,  is  severed  in  course 
of  time^  and  the  child  comes  out  of  the  uterus  (  into 
this  world  of  action  ).  On  the  other  hand,  as  a  fruit, 
worm-eaten  or  shaken  by  the  wind  or  a  blow,  untimely 
falls  to  the  ground,  so  will  a  foetus  be  expelled  out  of  its 
mother's  womb,  before  its  time.  For  four  months 
after  the  date  of  fecundation,  the  faetus  remains  in  a 
liquid  state,  and  hence  its  destruction  or  coming 
out  of  the  womb  goes  by  the  name  of  abortion.  In  the 
course  of  the  fifth  and  sixth  months  the  limbs  of  the  foetus 
gain  in  firmness  and  density,  and  hence,  its  coming  out 
at  such  a  time  is  called  miscarriage.     5-7. 

Prognosis  ; — The  enceinte  who  violently  tosses 
her  head  in  agony  (at  the  time  of  parturition)  and 
the  surface    of  whose    body   becomes    cold,  compelling 


58  THE  SUSHRUTA  SAMHITA.  [Chap.  VIH. 

her  to  forego  all  natural  modesty,  and  whose  sides 
and  abdomen  are  covered  with  nets  of  large  blue- 
coloured  veins,  invariably  dies  with  the  dead  child 
locked  in  her  womb.  The  death  of  the  foetus  in  the 
womb  may  be  ascertained  by  the  absence  of  movements 
of  the  foetus  (in  the  womb)  or  of  any  pain  of  child-birth, 
by  a  brown  or  yellow  complexion  of  the  enceinta,  cade- 
verous  smell  in  her  breath,  and  colic  pain  in  the  abdomen 
and  its  distension  owing  to  the  continuance  of  the  swollen 
and  decomposed  child  in  the  womb.    8-9. 

The  death  of  a  child  in  the  womb  may  result  from 
some  emotional  disturbance  of  its  mother,  (such  as 
caused  by  bereavement  or  by  loss  of  fortune  during 
pregnancy)  ;  while  an  external  blow  or  injury  (to  the 
womb)  or  any  serious  disease  of  the  mother  may  also 
produce  the  like  result.  A  child,  moving  in  the  womb 
of  a  dead  mother,  who  had  just  expired  (from  convulsions 
etc.)  during  parturition  at  term,  like  a  goat  (Vastamara) 
should  be  removed  immediately  by  the  Surgeon  from  the 
womb  (by  Caesarean  Section)  ;*  as  a  delay  in  extract- 
ing the  child  may  leads  to  its  death,     io-:i. 

*  Csecsarean  Section  means  incision  of  the  uterus  through  the  abdomi- 
nal walls  and  extrication  of  the  foetus  therefrom.  Operation  like  this  upon 
a  dead  subject  requires  no  skill  of  a  surgeon.  Any  one  can  do  it  without 
the  help  of  any  anatomical  knowledge.  In  modern  times,  when  the 
mother's  life  is  in  peril,  and  the  expulsion  of  the  foetus  becomes  nearly 
impossible,  by  the  natural  passage,  owing  to  an  existenee  of  deformity 
either  in  the  parturient  canal  or  in  the  forms  and  structures  of  the  foetus, 
to  save  both  mother  and  child  this  operation  is  principally  undertaken. 

The  evidence  of  similar  attempts,  in  ancient  India,  is  found  recorded 
in  passages  like  what  we  have  just  translated  and  that  the  operation  was 
practised  on  living  subjects,  there  is  not  the  least  doubt  about  it.  This 
custom  is  still  preserved  in  Central  Africa,  and  it  is  possible  that  the  Egyp- 
tians like  Hindu  philosophy  and  religion  learnt  this  also  from  the  Hindus. 
"Felkin,"  says  "Baas  in  his  History  of  Medicine  p.  70  "saw  a  case  of  the 
Csesarean  operation  in  Central  Africa  performed  by  a  man.     At  one  stroke 


Chap.  VlII.]  NIDANA  STHANAM.  ^9 

Additional  Text :— The  bladder  is  ruptured,  the  dead  child  lies 
like  a  weight  upon  the  placenta  and  is  pressed  upward  on  the  spleen,  liver 
and  gall  bladder.  The  mother  shivers  and  is  oppressed  with  tremor, 
dryness  of  the  tongue,  dyspnoea  and  perspiration.  She  complains  of 
a  cadaverous  smell  in  her  breath  and  stands  in  danger  of  imminent 
death.  By  these  symptoms  a  physician  shall  know  the  death  of  the 
child  in  the  womb.  This  portion  is  partly  recognised  by  Brahmadeva 
and  is  totally  rejected  by  Jejjadacharya  as  spurious. 

an  incision  was  made  through  both  the  abdominal  walls  and  the  uterus. 
The  opening  in  the  latter  organ  was  then  enlarged,  the  hemorrhage 
checked  by  the  actual  cautery,  and  the  child  removed.  While  an  assis- 
tant compressed  the  abdomen,  the  operator  then  removed  the  placenta. 
The  bleeding  from  the  abdominal  walls  was  then  checked.  No  sutures 
were  placed  on  the  walls  of  the  uterus  but  the  abdominal  parietes  were 
fastened  together  by  seven  figure-of-eight  sutures,  formed  with  polished 
iron  needles  and  threads  of  bark.  The  wound  was  then  dressed  with  a 
paste  prepared  from  various  roots,  the  woman  placed  quietly  upon  her 
abdomen,  in  order  to  favour  perfect  drainage,  and  the  task  of  the  African 
Spencer  "Wells  was  finished.  It  appears  that  the  patient  was  first  rendered 
half  unconscious  with  banana  wine.  One  hour  after  the  operation  the 
patient  was  doing  well.  And  her  temperature  never  rose  above  loi  F. 
nor  her  pulse  above  108.  On  the  eleventh  day  the  wound  was  completely 
healed,  and  the  woman  apparently  as  well  as  usual." 

W^hen  we  read  this  evidence  of  Felkin,  we  are  reminded  of  the  opera- 
tive steps  as  described  in  our  own  ancient  book  of  Surgery  from  which 
modern  surgeons  have  been  able  to  borrow  the  operation  of  rhinoplasty. 
It  is  a  great  pity  that  while  in  Africa  the  same  practice  is  still  retained 
intact,  we  in  India  by  spurious  attempts  and  disgraceful  contortions,  subs- 
titutions of  false  readings  and  dismal  knowledge  of  grammar  and  rhetoric 
try  to  prove  in  the  face  of  strong  evidence  that  in  ancient  India  Coesarean 
Section  was  attempted  only  on  cases  where  one  "might  not  perspire." 

If  we  take  f%qfligi:  in  the  sense  of  "a  woman  whose  life  is  in  great 
danger"  and  not  exactly  in  the  sense  of  "a  woman  who  is  dead"  as  recom- 
mended by  Dalian  and  Arundutta  (and  which  might  have  been  the 
meaning  if  instead  of  ^^^f^  a  word  like  o^iq^  had  been  used  in  the  text), 
we  find  at  once  that  Weber's  remark  in  his  History  of  Indian  Literature 
p.  270  *'that  in  Surgery  they  (the  Hindus)  attained  to  high  proficiency" 
is  not  based  on  the  solitary  evidence  of  rhinoplasty  alone. 

In  performing  obstetric  operations  with  success  examples  like  this  are 
not  rare.  If  the  two  different  readings  2f^?Ti'i;  ^"^l  ^f%^i^  be  taken  con- 
jointly into  consideration  we  are  impressed    with    the   idea   that  in  ancient 


6o  THE  SUSHRUTA  SAMHITA.  tChap.  VIlI. 

India  Csesarean  operations  were  very  frequently  undertaken  in  cases  of 
puerperal  eclampsia,  where  the  mother  had  been  in  the  deplorable  condi- 
tion of  a  goat  suffering  from  cramps  and  convulsions  as  well  as  in  cases 
of  an  accidental  death  not  unlike  that  which  fell  to  the  lot  of  the  poor 
mother  of  him  in  whose  name  the  operation  is  called.  ^g  =  goat  aii?[  = 
destroyer  (See  Monier  William's  Dictionary)  hence  a  goat-destroyer  =  a 
tiger  or  wolf)  or  in  cases  where  the  presence  of  deformity  in  the  parturient 
canal  or  of  malformation  of  the  foetus  prevented  the  natural  delivery  of  a 
living  child.  The  incision  is  not  to  be  made  anywhere  else  but  exactly 
in  the  place  where  Felkin  saw  the  illiterate  Negro  successfully  apply  his 
knife,  the  selection  of  ^f^'  %\\,^  as  suggested  by  some  commentators 
being  a  tempest  on  a  tea  pot  especially  when  the  subject  is  beyond  the 
grave.  In  a  living  subject  the  selection  of  a  proper  site  for  the  operation 
is  of  course  very  commendable.  Hence  we  venture  to  suggest  that 
extraction  of  the  living  foetus  from  the  womb  by  making  incision  through 
this  part  of  the  pelvis  was  also  attempted  later  on.  We  extract  here  the 
two  different  readings  and  leave  our  readers  to  judge  whether  we  are 
correct  to  draw  the  above  inferences. — Ed. 

f^^TJ  I     Bdgabhata  S'arira  Sihanam.     ch.  II.  slo.  53. 

Thus  ends  the  eighth  Chapter  of  the  Nidana  Sthanam  in  the  Sus'ruta 
Samhita,  which  treats  of  Nidanam  of  difficult  labour  and  false  presenta- 
tions. 


CHAPTER  IX. 

Now  we  shall  discourse  on  the  Niddnam  of 
Vidradhi  (abscess  etc.)-     I. 

The  blessed  Dhanvantari,  the  honoured  of  the  gods, 
who  for  the  promulgation  of  the  knowledge  of  the 
Ayurveda  and  for  administering  proper  medicines 
(to  the  sick),  took  his  birth  at  Kdsi,  (Benares)  as  a 
king,  thus  fully  discoursed  on  the  symptoms  of  Vidradhi 
(abscess  etc.)  to  his  disciple,  Sus'ruta.     2. 

Definition    and    classification  :— The 

extremely  deranged  and  aggravated  Vayu,  Pittam 
and  Kapham,  resorting  to  the  bone  and  vitiating 
the  Tvaka  (  skin  ),  blood,  flesh,  and  fat  of  a  person 
(with  their  own  specific  properties),  gradually  give 
rise  to  a  deep-seated,  painful,  round  or  extended 
swelling  which  is  called  Vidradhi  by  the  wise.  The 
disease  admits  of  being  divided  into  six  types  such  as 
the  Vataja  type,  the  Pittaja  type,  the  Kaphaja  type, 
the  Sdnnipatika  type,  the  Kshataja  type  (traumatic), 
and  the  Asrija  (which  has  its  seat  in  the  vitiated  blood). 
Now  we  shall  describe  their  specific  symptoms.     3-4. 

The  Vataja  Type  : — This  abscess  assumes  a 
black  or  vermilion  colour,  is  felt  rough  to  the  touch  and 
is  characterised  by  a  sort  of  excruciating  pain.  The 
growth  and  suppuration  of  the  abscess  are  brought 
about  in  a  variety  of  forms  (owing  to  the  variable 
and  irregular  action  of  the  deranged  Vayu  inolved  in 
these  cases).     5. 

The  Pittaja  Type  :— This  abscess  assumes  a 
blackish  yellow  colour  or  one  like  that  of  a  ripe  Audum- 
vara  fruit.  It  is  attended  with  fever  and  a  burning 
sensation,  and  is  of  rapid  growth  and  suppuration.  6. 


62  NIDANA   STHANAM.  Chap.  IX. ] 

The  Kaphaja  Type:— This  abscess  is  shaped 
like  an  Indian  saucer  (s'arava)  and  seems  cold  to  the 
touch.  It  assumes  a  light  yellow  colour  and  is  character- 
ised by  numbness,  itching  and  little  pain.  The  growth 
and  suppuration  of  this  abscess  is  very  slow.  The 
secretions  from  a  Vataja  abscess  are  thin,  those  from 
a  Pittaja  type  are  yellow,  while  the  exudations  from  a 
Kaphaja  abscess  are  white.     J. 

The   Sannipatika  Type:— An  abscess  of 

the  Sannipatika  type  is  of  varied  colour,  and  is  attended 
with  a  varied  sort  of  pain  (sucking,  drawing,  turning 
etc.)  and  exudes  secretions  of  various  colours  (white, 
yellow,  etc.).  It  is  little  raised  or  elevated  at  its  top, 
large  and  irregular  in  its  shape  and  does  not  uniformly 
suppurate  in  all  its  parts.     8. 

Agantuja  or  Kshataja  Type  :-~The  local 

or  inherent  heat  of  an  ulcer,  (caused  by  a  blow  or  a 
dirt)  in  a  person,  addicted  to  unwholesome  regimen,  is 
augmented  and  conducted  by  the  deranged  V^yu  and 
vitiates  the  blood  and  Pittam,  thus  giving  rise  to  a  kind 
of  abscess  which  is  known  as  the  Agantuja  Vidradhi 
(traumatic  abscess).  Symptoms  of  the  Pittaja  type  like- 
wise mark  this  type  of  abscess  and  fever,  thirst  and  a 
burning   sensation  attend  it  from  the  very  beginning.  9. 

The  Raktaja  Type:— This  abscess  assumes 
a  black  or  tawny  colour,  covered  with  a  large  number 
of  black  vesicles,  and  fever  and  an  intolerable  burning 
and  pain  attended  with  all  the  symptoms  peculiar  tOj 
the  Pittaja  type,  mark  the  present  form  of  the  disease. 
It  is  called  Raktaja  Vidradhi.  Of  external  Vidradhis 
or  abscesses,  those  of  the  Sannipatika  type  should  be 
regarded  as  incurable.     10 — 11. 

Antara-Vidradhi  :— Now   we   shall  describe 
the  characteristic  features  of  internal  abscesses   (Antara- 


[Chap.  IX.  THE   SUSHRUTA   SAMHITA  .  6$ 

VidradhI).  The  Vdyu,  Pittam  and  Kaphah  of  the  body, 
deranged  through  eating  heavy,  incompatible  and  in- 
congenial  (to  the  physical  temperament  of  the  eater) 
articles  of  food  or  of  dry,  putrid  and  decomposed  sub- 
stances, or  by  excessive  coition  and  fatiguing  physical 
exercise,  or  by  voluntary  repression  of  any  natural 
urging  of  the  body  or  through  the  eating  of  food  which 
is  followed  by  an  acid  reaction,  either  severally  or 
collectively  give  rise  to  a  tumour-like  (Gulma),  raised, 
or  elevated  abscess  in  the  interior  of  the  organism,  which 
is  often  felt  to  be  shaped  like  an  ant-hill.     12-13. 

Localities  :  — They  are  generally  found  to  be 
seated  at  the  mouth  (neck)  of  the  bladder,  or  about  the 
umbilicus,  or  in  the  sides,  or  in  the  Kukshi  (inguinal 
regions),  or  on  the  Vrikkas,  or  on  the  liver,  or  in  the 
heart,  or  on  the  Kloma,  or  on  the  spleen,  or  in  the 
rectum.  Their  general  characteristics  are  identical  with 
those  of  the  several  types  of  external  abscess.  The 
symptoms  of  their  suppurated  or  unsuppurated  stages 
should  be  determined  in  the  light  of  the  chapter  on 
Amapakvaishanyiam  (Ch  XVII  Sutra.).  14-15. 

Their   specific   symptoms  : -Now  hear 

me  describe  the  symptoms  which  specifically  mark  these 
internal  abscesses  according  to  their  seats  in  the  differ- 
j  ent  regions  of  the  organism.  An  abscess  appearing 
in  the  rectum  (Guda)  is  marked  by  the  suppression 
of  the  flatus  ( Vata).  Seated  in  the  bladder,  it  gives  rise 
to  difficulty  of  urination  and  scantiness  of  urine. 
Appearing  about  the  umbilicus  it  produces  a  distressing 
hic-cough  and  a  rumbling  sound  (Atopa)  in  the  intes- 
tines. Seated  in  either  of  the  sides  (Kukshi)  it  tends  to 
aggravate  inordinately  the  vayu  of  the  body.  Appear- 
ing in  the  inguinal  region  it  gives  rise  to  an  extreme 
catching  pain  at  the    back  and   waiyt.     Sea^ted  in  either 


64  NIDANA  STHANAM  [Chap.  IX. 

of  the  Vrikkas  it  brings  about  a  contraction  of  the  sides. 
Appearing  on  the  spleen,  it  produces  symptoms  of 
difficult  and  obstructed  respiration.  Seated  on  the  heart 
it  gives  rise  to  an  excruciating  and  piercing  pain  within 
its  cavity  and  a  drawing  pain  (Graha)  extending  all  over 
the  body  (D.  R. — cough).  Seated  in  the  Liver  its 
characteristic  indications  are  thirst  and  difficult 
breathing  (D.  R. — hic-cough)  whereas  a  sort  of  unquen- 
chable thirst  is  the  symptom  which  marks  its  seat  on 
the  Kloma.  16-17. 

Prognosis  : — An  abscess  appearing  on  any 
vital  part  (Marma)  of  the  organism,  whether  large 
or  small  in  size,  suppurated  or  unsuppurated,  should  be 
deemed  as  extremely  hard  to  cure.  Discharge  from  an 
abscess  formed  in  the  region  of  the  organism  above  the 
umbilicus  and  (spontaneously  bursting),  will  flow  out 
through  the  mouth  whereas  similar  secretions  from  down 
the  umbilical  region  of  (the  abdomen),  naturally  find 
an  outlet  through  the  fissure  of  the  anus.  The  case 
in  which  the  secretions  (pus  etc.)  find  a  down- 
ward channel  and  outlet  may  end  in  recovery  of  the 
patient;  whereas  the  one  in  which  the  secretions  take  an 
upward  course  invariably  proves  fatal.  An  incision 
made  by  surgeon  from  the  outside  into  an  internal 
abscess,  other  than  the  one  situated  on  the  heart,  or  on 
the  bladder  or  on  the  umbilicus  may  occasionally,  prove 
successful,  but  the  one,  seated  on  any  of  the  preceding 
vulnerable  visceras  (heart,  bladder  etc.)  of  the  body  and 
surgically  opened  invariably  ends  in  death.     18-19. 

A  woman,  who  has  miscarried  or  has  been  even 
safely  delivered  of  a  child  at  term,  may  be  afflicted  with 
a  dreadful  abscess  in  the  event  of  her  taking  injudi- 
cious and  unhwholesome  food  after  parturition.  The" 
?ibscess  in  such  a  case,  which  is   attended  with   extreme 


Chap.  IX.]  NIDANA   STHANAM.  65 

hyper-pyrexia  (Ddhajvara)  should  be  considered  as; 
having  had  its  origin  to  the  vitiated  blood  (Raktaja 
Vidradhi)  accumuVated  in  ,  the  organism.  The  abscess,, 
which  appears  in  the  Kukshi  (in  the  iliac  region)  of 
a  safely  delivered  woman  owing  to  the  presence  of  the 
unexpelled  blood-clots  in  those  regions  after  child- 
birth, should  be  also  diagnosed  as  a  case  of  Raktaja 
abscess.  The  unexpelled  blood  is  called  Makkalla* 
Such  an  abscess,  if  not  absorbed  in  the  course  of  a  week, 
is  sure  to  suppurate.     20  —  21. 

Differentiating  diagnosis  of  Gulma 
and  Vidradhi*  :— Now  I  shall  discuss  the  featuresi 

which  distinguish  a  Gulma  (internal  tumour)  from  a 
Vidradhi  (internal  abscess).  It  may  be  asked,  how  is 
it  that  Gulma,  (internal  tumour)  though  caused  by, 
and  involving  the  co-operation  of  the  same  deranged 
Doshas  as  an  internal  abscess,  does  nut  suppurate,  while 
the  latter  (Vidradhi)  does  run  to  suppuration  ?  22—23.. 
The  answer  is  that  a  Gulma  (internal  tumour),  though 
caused  by  the  same  deranged  Doshas  as  a  Vidradhi 
(internal  abscess),  does  not  resort  to  any  deranged 
organic  matter,  such  as  flesh,  blood,  etc.,  while,  on  the 
contrary,  in  a  case  of  Vidradhi,  the  diseased"  flesh  and 
blood  of  a  locality  are  in  themselves  transformed  into 
an  abscess.  An  internal  tumour  (Gulma)  is  like  a 
water  bubble  floating  and  moving  about  within  a  cavity 

*  A  Gulma  according  to  Sus'ruta  does  not  suppurate,  but  the  term 
*'Api"  (also)  contemplates  instances  in  which  a  Giil ma  rinay  suppurate 
as  in  the  case  where  it  has  got  its  basis  in  the- deranged  flesK  eVcr' of  the 
locality.  Charaka  asserts  that  retarded  digestion"  of  the  inges.ted -food 
followed  by  digestionary  acid  reaction,  colic  pain,  insomnia  with  fever 
and  a  non- relish  for  food  and  a  sense  of  oppcessiohi  etc.  ar«  thei symp- 
toms which  indicate  that  suppuration  Has  set  in  a  Gulma,  and  be '  adVises 
that  it  (Gulma)  should  be  treated^wixlrpouUices,  etc. 


66  THE   SUSHRUTA  SAMHITA.  [Chap.    IX. 

of  the  body  etc.  without  any  fixed  root  of  its  own. 
Hence,  it  is  that  a  Gulma  (internal  tumour)  does  not 
suppurate  at  all.  Suppuration  sets  in  in  an  abscess  only 
because  it  largely  contains  flesh  and  blood  unlike  a 
Gulma  (internal  tumour)  which  is  not  formed  of  any 
such  organic  matter,  and  depends  only  on  the  aggravated 
Doshas  giving  birth  to  it.  Hence,  a  Gulma  does  not 
suppurate  at  all.     24. 

Incurable   Types  :— A  case    of    an    internal 
abscess     suppurating     about    the     heart,     bladder     or 
umbilicus  as  well  as  one  of  the  Tridosha  type  (appearing 
in    any   part  of  the  organism)  should  be  given  up  as  in- 
curable.    The    abscess    in  which  the  marrow  suppurates 
(generally)   becomes    fatal.     The    suppurating  process  in 
an  internal  abscess,  which   generally  affects   the    under- 
lying bone,    is    sometimes    found    to    affect  the  marrow. 
The  suppurated  marrow,  failing    to    find    an    outlet   on 
account    of  the    compactness  of  the  local  flesh  and  bone, 
produces  a   sort   of  burning    sensation    in   the   localit}^ 
which   consumes   the    body    like    a   blazing    fire.      The 
disease     confined   to    the    bone,    like    a    piercing    dirt, 
torments   the    patient    for  a  considerable  length  of  time. 
An  incision  (made  into  the    affected    bone)    is   followed 
by  the   secretion    of  a   fat-like,  glossy,   white,  cold  and 
thick    pus.      Men,    learned    in    the   knowledge    of    the 
Medicinal     Sastras,    designate    such   an    abscess   as    an 
Asthighata-Vidradhi     (abscess     of     the     bone)     which 
involves  all  the  three  kinds  of  deranged  Doshas,  and  is 
attended  with  various  kinds  of  pain    which    mark  them 
respectively.     25-26. 

Thus  ends  the  ninth  Chapter   of  the   Nidanasthanam  in    the   Sui'rut^ 
3f^nbitd  which  treats  of  the  setiology  of  abscess. 


CHAPTER  X. 

Now  we  shall  discourse  on  the  Nidanam  of  Visar- 
pa    (erysipelas),    Nad!    (sinus)   and    Stana-roga 

(diseases  affecting  the  mammae  of  a  woman),     i. 

Definition  of  Visarpa  :~The  deranged  and 
aggravated  Doshas,  (Vayu,  Pittam  and  Kapham)  having 
recourse  to,  and  affecting  the  Tvaka  (Skin),  flesh  and 
blood,  speedily  give  rise  to  a  sort  of  shifting,  elevated 
swelling  (Sotha)  marked  by  the  characteristic  symptoms 
of  any  of  them  involved  in  the  case.  This  swelling  tends 
to  extend  all  over  the  body.  The  disease  is  called 
Visarpa  from  the  fact  of  its  extending  or  swiftly  shifting 
character  (Skr.  srip  -to  go,  to  extend).     2. 

The  Vataja  Type  :— The  swelling  (Sotha)  is 
soft  and  rough  and  assumes  a  black  colour  attended  with 
an  aching  pain  in  the  limbs  and  a  cutting  or  piercing 
pain  (in  the  affected  locality).  It  is  further  marked  by 
(all  the  usual)  symptoms  of  the  Vdtika  fever.  A  case  of 
this  type  in  which  uneven  flame  coloured  vesicles  or 
bulbs  appear  on  the  affected  part  through  the  extreme 
vitiation  (of  the  Vayu  and  Pittam)  should  be  given  up 
as  incurable.     3. 

The  Pittaja  and  Kaphaja  Types  :-Thc 

Pittaja  Visarpa  (erysipelas)  rapidly  extends  (over  the 
body),  attended  with  severe  fever,  a  burning  sensation, 
suppuration  and  cracking  (of  the  skin;.  A  large 
number  of  vesicles  appears  on  the  spot  which  as- 
sume a  blood-red  colour.  A  case  of  this  type, 
characterised  by  the  destruction  of  the  local  flesh  and 
veins  owing  to  the  excessively  aggravated  condition  of 
the     deranged    Doshas    (Kaphha   and    Pittam)     and    a 


68  THE  SUSHRUTA  SAMHITA.  [Chap.  X. 

collyrium-Iike  black  colour  (of  the  swelling),  should  be 
regarded  as  incurable.  The  Kaphaja  Visarpa  extends 
slowly  and  the  process  of  suppuration  is  tardy.  The 
affected  part  becomes  white,  glossy  and  swollen,  and 
is  marked  by  a  slight  pain  and  excessive  itching.     4-5. 

The  Sannipatika  Type  : -The  Visarpa  of 

the  Tridoshaja  type  is  deep-seated  and  the  affected 
part  assumes  all  colours  and  is  attended  with  all  sorts 
of  pain  which  are  peculiar  to  the  three  aforesaid  types. 
The  local  flesh  and  veins  are  destroyed  in  the  suppurating 
stage  of  this  disease  and  hence,  it  shouldbe  looked 
upon  as  incurable.     6. 

The  Kshataja  Type  (Erysipelas  due  to  a 
wound  or  an  ulcer):— The  Pittam  of  a  person  with  a 
temperament  marked  by  the  extreme  aggravation  of  all 
the  three  Doshas,  in  conjunction  with  the  blood,  resorts 
to  a  wound*  in  his  body  and  immediately  gives  rise  to 
Eiysipelas  (Sopha— lit  rash)  which  assumes  a  reddi.sh- 
brown  colour,  with  high  fever  with  a  burning  sensation, 
and  suppuration  in  its  train,  and  it  is  found  to  be 
covered  with  black  vesicles  to  the  size  of  Kulattha 
pulse.     7. 

Prognosis  : — The  Vataja,  Pittaja  and  Kaphaja 
Visarpas  are  curable ;  the  Sannipdtika  and  Khataja 
ones  being  incurable.  The  symptoms,  which  indicate 
an  unfavourable  prognosis  in  a  case  of  Vdtaja  or 
Pittaja  Erysipelas,  have  been  described  before.  Those, 
which  attack  the  vital  parts  (Marmas)  of  the  body,  can 
be  cured  only  with  the  greatest  difficulty.i*     8. 

*  Or  through  the  extreme  augmentafion  of  all  the  three  doshas  in 
the  ulcer  (Sadyah-kshata-Vj  ana)  according  to  others. 

t  Golden  coloured  (yellow)  Erysipelas  due  to  the  action  of  the 
(deranged)  Pittam  is  incurable  (AV/a/wa  /^h-tichana-vapuicha  ta^hi  na 
sydhyet.).''V>.  R. 


Chap.  X.]  ,       NIDANA  STHANAM.  69 

The  N^ldi-Vrana  :~The  pus  of  an  abscess  or 
swelling  burrows  into  the  affected  part  if  a  person 
neglects  it  in  its  fully  suppurated  stage,  dubious  of  its 
being  so  conditioned,  or  not,  or  even  neglects  to  open  a 
fully  suppurated  abscess.  An  abscess  or  swelling  is 
called  a  Gati  Vrana  owing  to  an  excessive  infiltration 
of  pus,  and  it  is  also  called  a  N^di-vrana  owing  to  the 
presence  of  a  large  number  of  recesses  or  cavil ies  in 
its  inside.  There  are  five  different  types  of  Nddi-vrana 
(sinuses)  such  as  the  Vdtaja,  Fittaja,  Kaphaja,  Tridoshaja 
and    Salyaja.  9—  10. 

The    Vataja,    Kaphaja   and    Pittaja 

Types  :~The  V^fcaja  SiEUS  is  rough  and  short- 
mouthed,  characterised  by  an  aching  pain  (in  its  inside). 
It  exudes  a  sort  of  frothy  secretion  which  becomes 
greater  at  night  and  is  attended  with  an  aching  pain. 
Thirst,  lassitude,  heat  and  a  piercing  pain  jn  the  affected 
locality)  are  the  usual  accompaniments  of  the  Pittaja 
types.  Fever  is  present  from  the  beginning  and  the  Sinus 
exudes  a  large  quantity  of  hot  and  yellow  coloured 
secretion  which  is  more  by  day  than  by  night.  The 
Kaphaja  Sinus  becomes  hard  and  is  characterised  by 
'itching  and  a  slight  pain  (numbed  ?).  It  is  found  to 
secrete  a  copious  quantity  of  thick,  shiny,  white-coloured 
pus  which  becomes  greater  at  night.     11-13. 

Dvandaja  and  Tridoshaja  Types  :— 

A  case  of  Nddi-Vrana  involving  the  concerted  action 
•of  any   two    of  the   deranged    Doshas   (Vayu,    Pittam 

and  Kapham)  and  exhibiting  symptoms  peculiar  to 
•  both,    is  called    a  Dvandaja*  one.     There  are     three 


*  Gayadasa  does  not  read  the  symptoms  of  Dvi-doshaja  (?.<;.,  due 
to  two  morbific  principles)  types  of  sinus  a  g  ven  in  the  text  which 
he  has  rejected  as  spurious 


70  THE  SUSHRUTA  SAMHITA^  [Chap.  X. 

types  of  this  class  of  disease,  (such  as  the  Vata-pittaja, 
Vhta-kaphaja  and  Pitta-kaphaja)  A  case  of  Na'di- 
vrana,  exhibiting  symptoms  of  the  three  aforesaid  types, 
and  attended  with  fever  and  a  burning  sensation,  diffi- 
cult breathing,  dryness  of  the  mouth  and  syncope,  is 
called  Tridoshaja.  An  attack  of  this  type  should 
be  regarded  as  dreadful  and  fatal,  casting  around  the 
gloom  of  death.     I4-I5- 

The    ^alyaja    Nadi-Vrana  :— A    foreign 

matter  (such  as  dirt,  bone,  splinter  etc.),  lodged  within 
the  body  and  invisible  to  the  eye,  tends  to  burst  open 
the  skin,  etc.  of  the  locality  along  its  channel  of  inser- 
tion and  gives  rise  to  a  type  of  Sinus.  It  is  character- 
ised by  a  constant  pain,  and  suddenly  and  rapidly 
exudes  a  sort  of  hot,  blood-tinged,  agitated,  frothy  secre- 
tion. This  type  is  called  Salyaja.     i6. 

ThcStana-Roga: — These  may  be  divided  into 
as  many  types  as  the  aforesaid  Nadi-Vrana  and  are 
caused  by  the  same  exciting  factors  as  the  last  named 
malady.  The  milk-carrying  ducts  remain  closed  in  the 
breast  of  a  nullipera  thus  barring  the  possibility  of  the 
descent  of  the  Doshas  through  them  and  of  an  attack 
of  any  disease  at  that  part  of  the  body.  On  the 
contrary,  such  ducts  in  the  breast  of  a  piimipara  open 
and  expand  of  their  own  accord,  thus  making  the 
advent  of  diseases  possible  that  are  peculiar  to  the 
mamma.     I7-I9- 

The  breast-milk  :  -The  sweet  essence  of  the 
Rasa  (lymph  chyle)  drawn  from  the  digested  food 
courses  through  the  whole  body  and  is  ultimately  con- 
centrated in  the  breast  of  a  mother  or  a  woman  (big 
with  child)  which  is  called  milk.     2o. 

Its  character  :— The  breast-milk,  like  semen, 
lies     hidden     and     invisible    in    the    organism,   though 


Chap.  X  ]  NIDANA   STHANAM.  /r 

permeating  it  in  a  subtle  or  essential  form.  The  charac- 
teristic features  of  the  breast-milk  bear  analogy  to  those 
of  semen  The  breast  milk  is  secreted,  and  flows 
out  at  the  touch,  sight  or  thought  of  the  child  in  the 
same  manner  as  the  semen  is  dislodged  and  emitted 
at  the  sight,  touch  or  recollection  etc.  of  a  beloved 
woman.  As  the  strong  and  unclouded  affections  of  a 
man  are  the  cause  of  the  emission  of  semen,  so  the  fondest 
love  of  a  mother  for  her  children  brings  about  the  secre- 
tion of  her  breast-milk  Both  semen  and  breast-milk  are 
the  product  of  the  essence  of  digested  food,  this  essence 
being  converted  into  milk  in  women.     21 — 22. 

Its  abnormal  and   normal    Traits:  — 

The  milk  of  a  mother  vitiated  by  the  deranged  Vayu 
of  her  system  has  an  astringent  taste  and  floats  on 
water  The  milk  of  a  mother  vitiated  by  the  deranged 
Pittam  has  an  acid  and  pungent  taste  and  becomes 
marked  with  a  yellow  hue,*  if  left  to  float  on  water.  The 
milk  of  a  mother  vitiated  by  the  deranged  Kapham 
is  thick  and  slimy  and  sinks  in  water.  The  milk  of  a 
mother  vitiated  by  the  concerted  and  simultaneous 
derangement  of  the  three  Doshas  of  the  body  is  marked 
by  the  combination  of  all  the  preceding  symptoms.  An 
external  blow  or  hurt  too  (Abhighata)  sometimes  pro- 
duces vitiation  of  the  mother's  milk.     23. 

The    milk    (of  a  mother),  which  instantly  mixes  with 
water,  tastes  sweet  and  retains    its   natural    greyish   tint, 

should  be  regarded  as  pure.     24. 

The    bodily  Do.shas  having  recourse  to  the  breasts  of 

a  woman  whether  filled  with  milk  or   not   and    vitiatinsf 

o 

the  local  flesh  and  blood  give  rise  to   mammary  diseases, 

*     The  particle   'Cha"    in    the  text  indicates  that  the  colour  may  turn 
blue  or  pink  in  some  cases. 


72  THE  SUSHRUTA  SAMHITA.  [Chap.  X. 

(Stana-roga).  All  the  types  of  abscess  (Vidradhi) 
excepting  the  one  called  the  Raktaja  out  of  the  six 
types  desciibed  before  are  found  to  attack  the  mammae^ 
and  their  symptoms  should  be  understood  as  identical 
with  those  of  external  abscesses.     25. 

Thus  ends  the  tenth  Chapter  of  the  Nidaram  Sthdnam  in  the  Su&'ruta 
Samhit^  w  ich  treats  of  the  oetiolcgy  and  symptoms  of  Erysipelas,  vSinus 
and  mammary  abscesses. 


CHAPTER  XL 

Now  we  shall  discourse  on  the  Nid^nam  of  Granthi 
(Glands  etc.),  Apachi  (Scrofula  etc.),  Arvudi  (Tumours) 
and  Gralagand a  (Goitre),     i. 

The  deranged  and  unusually  aggravated  Vayu  etc. 
(Pittam  and  Kapham),  by  vitiating  the  flesh,  blood  and 
fat  mixed  with  the  Kapham  (of  any  part  of  the  or- 
ganism), give  rise  to  the  formation  of  round,  knotty, 
elevated  swellings  which  are  called  Granthi  (Glandular 
inflammation).     2. 

The  Dosha-Origined  Types  :— The  swell- 
ing (Sopha)  of  the  Vaitatja  type  seems  as  if  it  were 
drawn  into  and  elevated  or  as  if  severed  or  pricked 
with  a  needle,  cleft  in  two  or  drawn  asunder  or  as  if 
cut  in  two  or  pierced.  The  knotty  growth  assumes  a 
black  colour,  and  is  rough  and  elongated  like  a  bladder. 
On  bursting  a  granthi  of  this  type  exudes  clear  bright 
red  blood.  The  Fittaja  Granthi  is  characterised  by 
heat  and  an  excessive  burning  sensation  (in  its  inside). 
A  pain,  like  that  of  being  boiled  by  an  alkali  or  by 
fire,  is  felt  in  the  inside.  The  knotty  formation  assumes 
a  red  or  yellowish  colour  and  exudes  a  flow  of  extremely 
hot  blood  on  bursting.  The  Kaphaja  Granthi  is  slightly 
discoloured  and  cold  to  the  touch.  It  is  characterised 
by  a  slight  pain  and  excessive  itching,  and  feels  hard 
and  compact  as  a  stone.  It  is  slow  or  tardy  in  its 
growth  and  exudes  a  secretion  of  thick  white-coloured 
pus  when  it  bursts.     3-5. 

The  Medaja  Type  :— The  fat  origined  Gran- 
thi is  large  and  glossy  and  gains  or  loses  in  size  with 
the  gain    or    loss   of  flesh  by  the  patient.     It  is  marked 

10 


74  THE  SUSHRUTA  SAMHItA.  [Chap.  Xt. 

by  a  little  pain  and  an  excessive  itching  sensation  and 
exudes  a  secretion  of  fat  resembling  clarified  butter  or 
a  gruel,  in  colour  and  consistency,  made  of  the  levigated 
paste  of  sesamum  on  bursting.     6. 

Si ra-Granthi— (aneurism  or  varicose  veins)  : — 
The  bodily  Vayu  in  weak  and  enfeebled  persons,  de- 
ranged by  over-fatiguing  physical  exercises,  straining  or 
exertion  or  by  pressure,  presses  on,  contracts,  dries  or 
draws  up  the  ramifications  of  veins  (Sira)  or  arteries 
(of  the  affected  locality),  and  speedily  gives  rise  to  a 
raised  knotty  formation  which  is  called  a  Sira-Granthi, 
In  the  event  of  its  being  shifting  and  slightly  painful, 
it  can  be  cured  only  with  the  greatest  difficulty. 
Whereas  a  case  in  which  the  knotty  formation  is  pain- 
less, fixed,  large  and  situated  at  any  of  the  vital  parts  of 
the  body  (Marmas),  should  be  deemed  incurable.*    7. 

Apachi — (Scrofula  etc.)  : — The  augmented  and 
accumulated  fat  and  Kapham  give  rise  to  string  of  hard 
glossy,  painless,  nodular,  or  elongated  granthi  (swellings) 
about  the  joints  of  the  jawbones,  at  the  waist,  joint, 
about  the  tendons  of  the  neck,  about  the  throat  or  about 
the  region  of  the  arm-pits.  These  glands  (Granthis)  re- 
sembling the  stones  of  the  Amalaka  fruit  or  the  spawn 
of  fish  in  shape  or  like  some  other  shape,  are  of  the  same 
colour  as  the  surrounding  skin  ;  and  a  string  or  a  large 
crop  of  such  glandular  knots,  gradually  growing  is 
called  Apachi-f- on  account  of  the  extensive  nature  of 
their  growth.     8-9. 

*  In  several  editions  an  additional  line  is  to  be  found  running  as  men 
well  conversant  with  symptoms  (of  Gtanthis)  recognise  a  type  of  Granthi 
due  to  the  action  of  the  deranged  flesh  and  blood,  which  exhibits  symp- 
toms identical  with  those  of  a  tumour  {Mansjtasrayam  chdrvuda 
laskhanena  tulyam  hi  drish/awaih  lakshanajunih).  But  Jejjata  has 
rejected  it  as  of  questionable  authority. 

t  These  glandular  formations  appear  about  the  root  of  the  penis,  about 
the  sides,  in  the  arm-pits  and  about  the  throat  and  the  tendons  of  the  neck. 


Chap.   XI.]  NIDANA   STHANAM.  75 

These  knotty  formations  are  characterised  by  itching 
and  a  slight  pain.  Some  of  them  spontaneously  burst 
exuding  secretions  while  others  are  observed  to  vanish 
and  re-appear  (in  succession).  Such  vanishings,  re- 
appearances, or  fresh  formations  continue  for  a  consider- 
able time.  The  disease  undoubtedly  owes  its  origin  to 
the  deranged  fat  and  Kapham,  and  may  only  be  made 
amenable  (to  medicine)  with  the  greatest  difficulty 
lasting  for  years  at  a  time.     lO. 

ArVUda— (tumour  etc.)  : — The  large  vegetation 
of  flesh  which  appears  at  any  part  of  the  body,  becomes 
slightly  painful,  rounded,  immovable  and  deep-seated, 
and  has  its  root  sunk  considerably  deep  in  the  affected 
part,  and  which  is  due  to  the  vitiation  of  the  flesh 
and  blood  by  the  deranged  and  aggravated  Doshas 
(Vayu,  Pittam  and  Kapham)  is  called  an  Arvuda 
(tumour)  by  the  learned  physicians*.  The  growth  of 
an  Arvuda  is  often  found  to  be  slow,  and  it  seldom 
suppurates.  The  characteristic  symptoms  of  an  Arvuda 
which  owes  its  origin  to  the  deranged  condition  of  the 
Vayu,  Pittam,  Kapham,  flesh  or  fat,  are  respectively 
identical  with  those,  which  mark  the  cases  of  Granthis, 
brought  about  by  the  same  deranged  principles  of  the 
body.     II. 

Raktaja— Arvuda  :— The  deranged  Doshas 
(Vayu,    Pittam  and  Kaphami)   contracting,  compressing 


They  resemble  spawns  of  fish  in  shape  and  size  and  are  due  (o  the  action 
of  the  deranged  Vayu,  Pitiam  and  Kapham.  The  appearance  ol  such 
glands  in  the  upper  part  of  the  body  should  be  attributed  to  the  aciicn 
of  the  deranged  and  aggravated  Vayu.  They  are  ixtremdy  hard  to  cure 
inasmuch  as  their  growth  (formation)  involves  the  concerted  action 
of  the  morbific  principles  (Doshas)  of  the  body. — Bhoja. 

Charaka,     who   designates   this    disease   as   Gandatncild,    describes  its 
location  in  regions  about  the  jawbones  alone. 

*  That    they   having     recourse     lo    the     flesh,     produce    deep-seated 
vegetations  (of  flesh)  is  the  reading  adopted  by  Gayadasa  and  ot>iers. 


76  THE  SUSHRUTA  SAM  HIT  A.  [Chap.  XI. 

and  drawing  the  vessels  (Sira)  and  blood  (of  the  affec- 
ted partj,  raise  a  slightly  suppurated  and  exuding 
tumour  which  is  covered  with  small  warts  and  fleshy 
tubercles  and  is  called  a  Raiktatrvuda.  This  tumour  is 
rapid  in  its  growth  and  exudes  a  constant  flow  of 
(vitiated)  blood.  The  complexion  of  the  patient  owing 
to  depletive  actions  and  other  concomitant  evils  of 
haemorrhage  becomes  pale  and  yellow.  The  type 
should  be  considered  incurable  on  account  of  its  having 
its  origin  in  the  blood.*     12 — 13. 

IVIansarvuda  :— The  flesh  of  any  part  of  the 
body  hurt  by  an  external  blow  etc.  (hurting  it  with  a 
log  of  wood — D.R.)  and  vitiated  in  consequence,  gives 
rise  to  a  sort  of  swelling  (tumour)  which  is  called 
Mdnsarvuda,  which  originates  through  the  action  of 
the  deranged  Vdyu.  It  is  glossy,  painless,  non-sup- 
purating, hard  as  a  stone,  immobile,  and  of  the  same 
colour  as  the  surrounding  skin.  Such  a  tumour 
appearing  in  a  person  addicted  to  meat  diet  becomes 
deep  seated  owing  to  the  consequent  vitiation  of  the 
bodily  flesh  and  soon  lapses  into  one  of  an  incurable 
type.     14. 

ProgTIOSIS  :— Even  of  the  aforesaid  curable 
types  (such  as  the  Vataja,  etc.^,  the  following  types  of 
Arvudam  (tumours)  should  be  likewise  regarded  as  incur- 
able, those  which  appear  in  the  cavity  of  a  Srota  chan- 
nel or  an  artery  ,  or  any  vulnerable  joint  of  the  body  and 
arc  characterised  by  any  sort  of  secretion  and  also  im- 
movable, should  be  deemed  incurable.  An  Arvudam 
(tumour)   cropping   up   on    one    existing  from  before  is 


*  Although  all  types  of  Arvuda  have  their  origin  in  the  deranged  flesh 
and  blood,  i)reponderant  action  of  the  deranged  blood  is  found  in  Raktd- 
arvuda^  while  a  dominant  action  of  the  deranged  flesh  marks  the 
MAmArvuda  type. 


Chap.  XI.  NIDANA   STIIANAM.  TJ 

called  Adhyarvudam,  which  should  be  likewise  deemed 
as  incurable.  A  couple  of  contiguous  Arvudam  (tumours) 
cropping  up  simultaneously  or  one  after  another  is  called 
Dviarvudam,  which  should  be  held  as  equally  incurable 
(with  one  of  the  foregoing  types).  An  Arvuda  (tumour) 
of  whatsoever  type,  never  suppurates  owing  to  the 
exuberance  of  the  deranged  Kapham  and  fat  as  well 
as  in  consequence  of  the  immobility,  condensation  and 
compactness  of  the  deranged  Doshas  (Vayu,  Pittam  and 
Kapham  involved  in  the  case,  or  out  of  a  specific  trait 
of  its  own  nature.     15-16. 

Definition  of  Galaganda  (Goitre;:— The 

deranged  and  aggravated  Vayu  in  combination  with  the 
deranged  and  augmented  Kapham  and  fat  of  the  loca- 
lity affects  the  two  tendons  of  tne  neck  (Manyds)  and 
gradually  gives  rise  to  a  swelling  about  that  part  of  the 
neck  characterised  by  the  specific  symptoms  of  the 
deranged  Doshas  (Vayu  or  Kapham)  and  principles  in- 
volved in  the  case.  The  swelling  is  called  Galganda 
(Goitre).     17. 

Symptoms    of  the    Dosha-orig-ined 

Types  : — The  swelling  or  tumour  in  the  Va^tajai  goitre 
is  characterised  by  a  pricking  pain  (in  its  inside)  marked 
by  the  appearance  of  blue  or  dark  coloured  veins  Sira) 
on  its  surface.  It  assumes  a  vermilion  or  tawny  brown 
hue.  The  goitre  becomes  united  with  the  local  fat 
in  course  of  time,  and  gains  in  size,  giving  rise  to  a 
sense  of  burning  in  the  throat,  or  is  characterised  by 
the  absence  of  any  pain  at  all.  A  Vataja  goitre  is  rough 
to  the  touch,  slow  in  its  growth,  and  never  or  but  rarely 
suppurates.  A  sense  of  dryness  in  the  throat  and  the 
palate  as  well  as  a  bad  taste  in  the  mouth  likewise 
marks  this  type.  The  swelling  in  the  Kaphaja  Type 
assumes    a   large    shape   and  becomes    hard,  firm,   cold 


78  THE   SUSHRUTA   SAMHITA.  [Chap.  XI. 

and  of  the  same  colour  (white).  There  is  but  slight  pain 
and  the  patient  feels  an  irresistible  inclination  to  scratch 
the  part.  It  is  slow  in  its  progress  and  suppuration  is 
rare  and  tardy.  A  sweet  taste  is  felt  in  the  mouth  and 
the  throat  and  the  palate  seem  as  if  smeared  with  a  sort 
of  sticky  mucous.     18-20. 

Symptoms    of    the   IVledaja  Type:— 

The  swelling  is  glossy,  soft  (heavy — D.R)  and  pale- 
coloured.  It  emits  a  fetid  smell  and  is  characterised  by 
excessive  itching  and  an  absence  of  pain.  It  is  short  at 
its  root  and  hangs  down  from  the  neck  in  the  shape  of  a 
pumpkin  (Aldvu),  gradually  gaining  its  full  rotundity  at 
the  top.  The  size  of  the  goitre  is  proportionate  to  the 
growth  or  loss  of  flesh  of  the  body.  The  face  of  the 
patient  looks  as  if  it  has  been  anointed  with  oil  and  a 
peculiar  rumbling  sound  is  constantly  heard  in  the 
throat.     21. 

Prognosis  :  -  A  case  of  goitre  attended  with 
difficult  respiration,  a  softening  of  the  whole  body, 
weakness,  a  nonrelish  for  food,  loss  of  voice  as  well  as 
the  one  which  is  more  than  of  a  year's  standing  should 
be  abandoned  by  the  physician  as  incurable.     22. 

Metrical  Text:  — A  pendent  swelling  whether 
large  or  small  and  occurring  about  the  region  of  the 
throat  and  resembling  the  scrotum  in  shape  is  called 
a  Gala-Ganda.     23. 

Thus  ends   the   eleventh    Chapter   of    the    Niddna    Sthanam   in    the 
Susruta  Samhita  which  treats  of  the  Nidanam  of  Granlhi,  Scrofula,   «lc. 


CHAPTER   XII 

Now  we  shall  discourse  on  the  Nidanamof  Vriddhi 
(hydrocele,  hernia,  scrotal  tumours  etc),  Upaclansa 
(disease  of  the  genital  organ*,  and  Slipada  (ele- 
phantiasis),     I . 

Classes  :  -There  are  seven  different  types  of 
Vriddhi  such  as  the  Vataja,  Pittaja,  Kaphaja,  Raktaja, 
Medaja,  Mutraja  and  the  Antra-vriddhi.  Of  these  both 
the  Mutraja-vriddhi  (hydrocele  or  extravagation  of  the 
urine),  and  Antra-vriddhi  types,  though  owing  their  ori- 
gin to  the  deranged  condition  of  the  bodily  Vayu,  have 
been  so  named  after  the  organic  matters  or  anatomical 
parts  (urine,  iliac  colon  etc.)  involved  in    them.     2. 

Definition  and  Premonitory  symp- 
toms : — Any  of  the  deranged  Doshas  (Vayu,  Pittam, 
etc )  lying  in  the  nether  regions  of  the  body  may  resort 
to  the  spermatic  cords  (Dhamani)  and  give  rise  to  a 
swelling  and  inflammation  of  Phalacosha  (scrotal  sac) 
which  is  called  Vriddhi  (scrotal  tumour  etc.).  A  pain 
in  the  bladder,  scrotum,  penis  and  the  waist  (Kati) 
incarceration  of  the  Vayu  and  the  swelling  of  the 
scrotum,  are  the  premonitory  symptoms  of  the 
disease.     3 — 4. 

The  Dosha-origined  Types  :— The  type 

in  which  the  scrotum  becomes  distended  with  Vayu 
like  an  inflated  air-drum,  marked  by  roughness  of 
(its  surface)  and  the  presence  of  a  varied  sort  of  Vataja 
pain  (in  its  interior)  without  any  apparent  cause  is  called 
Vataja  Vriddhi.  The  swollen  scrotum,  of  the 
Pittaja     Vriddhi,    assumes     the     colour      of    a      ripe 


8o  THE   SUSHRUTA   SAMHITA.  [Chap.   XII. 

Audumvara  fruit  and  is  attended  with  fever,  a  burning 
sensation  and  heat  in  the  affected  part.  It  is  of  a 
marked  rapid  growth  and  speedy  suppuration  (of  the 
scrotum).  The  swollen  organ  in  the  Kaphaja  Vriddhi 
becomes  hard  and  cold  to  the  touch  accompanied  by- 
little  pain,  and  itching  (in  the  affected  part .  In  the 
Raktaja  type  the  swollen  scrotum  is  covered  over  with 
black  vesicles,  all  other  symptoms  of  the  type  being 
identical  with  those  of  the  Pittaja  one.  In  the  Medaja 
type  the  swollen  scrotum  looks  like  a  ripe  TMa  fruit 
and  becomes  soft,  glossy  and  slightly  painful.  The 
patient  feels  a  constant  inclination  to  scratch  the  part. 
The  Mutraj a- vriddhi  (hydrocele)  owes  its  origin  to 
a  habit  of  voluntary  retention  of  urine,  its  characteristic 
symptoms  being  softness  and  fluctuation  on  the  surface 
of  the  swollen  scrotum  like  a  skin-bladder  filled  with 
water,  painful  urination,  pain  in  the  testes  and  swelling 
of  the  scrotum.     5. 

Antra-vriddhi  (Inguinal  hernia)  :— The  local 
Vayu  enraged  and  unusually  aggravated  by  lifting  a 
great  load,  wrestling  with  a  stronger  person,  violent 
physical  strain  or  a  fall  from  a  tree  and  such  like 
physical  labour  doubles  up  a  part  of  the  small  intestine 
and  presses  it  down  into  the  inguinal  regions  lying 
there  strangulated  in  the  form  of  a  knot  (Granthi) 
which  is  known  as  Antra-vriddhi  (inguinal  hernia). 
The  part  not  properly  attended  to  at  the  outset 
descends  into  the  scrotum  which  becomes  ultimately 
elongated  and  intensely  swollen  and  looks  like  an 
inflated  air-bladder.  It  (hernia)  ascends  upwards  under 
pressure,  making  a  peculiar  sound,  (gurgling)  ;  while  let 
free  it  comes  down  and  again  gives  rise  to  the  swelling 
of  the  scrotum.  This  disease  is  called  Antra-vriddhi 
and  is  incurable.     6. 


Chap.  XII.]  NIDANA  STHANAM.  8l 

TheUpadansam:— An  inflammatory  swelling 
of  the  genital,  whether  ulcerated  or  not  is  called 
TJpadansa*.  The  disease  owes  its  origin  to  the 
action  of  the  local  Doshas,  aggravated  by  promiscuous 
and  excessive  sexual  intercourse,  or  by  entire  absti- 
nence in  sexual  matter  ;  or  by  visiting  a  woman,  who 
had  observed  a  vow  of  lifelong  continence  or  one  who  has 
not  long  known  a  man,  or  one  in  her  menses  or  one  with 
an  extremely  narrow  or  spacious  vulva,  or  with  rough  or 
harsh  or  large  pubic  hairs  ;  or  by  going  unto  a  woman 
whose  partturient  canal  is  studded  with  hairs  along  its 
entire  length ;  or  by  visiting  a  woman  not  amorously 
disposed  towards  the  visitor  and  vice  versa  ;  or  by  know- 
ing a  woman  who  washes  her  private  parts  with  foul 
water  or  neglects  the  cleanliness  of  those  parts,  or  suffers 
from  any  of  the  vaginal  diseases,  or  one  whose  vagina 
is  naturally  foul ;  or  by  going  unto  a  woman  in  any  of 
the  natural  fissures  of  her  body  other  than  the  organ  of 
copulation  (Vi-yoni) ;  or  by  pricking  the  genital  with 
finger  nails,  or  biting  it  with  the  teeth,  or  through  poison- 
ous contact,  or  through  practice  of  getting  the  (penis 
abnormally  elongated  by  pricking  the)  bristles  of  a 
water   parasite   {Suka)   into  its  body  ;  or  by    practising 

*  Upadans'a  is  not  syphilis  whole  to  whole.  Certain  types  of 
Upadans'a  such  as  the  Raktaja  and  Sannipatika  types  which  entail  the 
destruction  of  the  organs  concerned  exhibit  certain  symptoms  which  are 
common  to  syphilis  as  well.  The  secondary  eruptions  and  tertiary 
symptoms  of  syphilis  are  not  mentioned  by  ihe  A'yurvedic  Rishis  who 
used  to  treat  it  only  with  vegetable  medicines  and  this  fact  intimates 
the  probability  that  the  secondary  and  tertiary  symptoms  of  syphilis 
might  not  arise  by  their  efficient  and  able  treatment  from  the  very 
beginning,  preventing  the  absorption  of  the  poison  into  the  system. 
The  practice  of  ablution,  so  common  among  the  Hindus,  might  be 
taken  into  consideration  as  one  of  the  important  preventive  factors. 
Maharshi  Cbaraka  has  comprised  it  within  the  chapter  on  'Senile 
Impotency'.— Ed, 


g2  THE  SUSHRUTA   SAMHITA.  [Chap.  XII. 

masturbation,  or  any  unnatural  offence  with  female 
quadrupeds ;  or  by  washing  the  genitals  with  filthy  or 
poisonous  water  ;  or  through  neglect  to  wash  the  parts 
after  coition,  or  voluntary  suppression  of  a  natural  flow 
of  semen  or  urine  or  through  any  hurt  or  pressure 
on  the  organ  etc.  The  inflammation  of  the  genital 
thus  engendered  is  called  Upadans'a.  The  disease 
admits  of  being  divided  into  five  distinct  types,  such 
as,  the  Vitaja,  Pittaja,  Kaphaja,  Tridoshaja  and  the 
Raktaja.     7—8. 

The  symptoms  of  different  Types:— 

The  roughness  of  the  genitals,  the  bursting  or  cracking 
of  the  integuments  of  the  penis  and  prepuce  etc.,  numb- 
ness and  swelling  of  the  aff'ected  part  which  is  perceived 
rough  to  the  touch  and  the  presence  of  a  varied  sort  of 
pain  peculiar  to  the  deranged  Vayu  are  the  characteristic 
indications  of  the  Vattaja  type.  In  the  Pittaja  type 
fever  sets  in  (from  the  very  beginning),  the  penis  becomes 
swollen  and  assumes  the  colour  of  a  ripe  Indian  fig 
(reddish-yellow),  attended  with  a  sort  of  intolerable 
burning  sensation.  The  process  of  suppuration  is  rapid 
and  a  variety  of  pain  peculiar  to  the  deranged  Pittam, 
(distinguishes  it  from  the  other  forms  of  the  disease). 
The  penis  becomes  swollen,  hard  and  glossy  in  the 
Kaphaja  type  marked  by  itching  and  a  variety  of 
pain  characteristic  of  the  deranged  Kapham.  In  the 
blood-origined  type  (Raktaja)  the  organ  bleeds  heavily 
and  is  covered  with  the  eruptions  of  large  black  vesicles. 
Fever,  thirst,  (Sosha),  burning  sensations  and  other 
characteristic  symptoms  of  the  deranged  Pittam  are  also 
present.  Palliation  is  all  that  can  be  occasionally  effected 
in  these  cases.  Symptoms  specifically  betraying  to  each 
of  the  Vataja,  Pittaja  and  Kaphaja  types  concurrently 
manifest  themselves  in   the   Satnnipaitika  type  of  Upa- 


Chap.  XII.]  NIDANA  STHANAM.  83 

dansa.  The  organ  cracks,  the  ulcers  or  cancers  become 
infested  with  parasites  and  death  comes  in  to  put  a  stop 
to  the  suffering  of  its  wretched  victim.     9—13. 

^lipadam  (Elephantiasis) :- The  disease  in  which 
the  deranged  Vayu,  Pittam  and  Kapham,  taking  a  down- 
ward course,  are  lodged  in  the  thighs,  knee-joints,  legs 
and  the  inguinal  regions  and  spread  to  the  feet  in  course 
of  time  and  gradually  give  rise  to  a  swelling  therein, 
is  called  Siipadam.  There  are  three  types  of  Slipada 
severally  due  to  the  actions  of  the  deranged  Vayu, 
Pittam  and  Kapham.     14—  15. 

The    symptoms    of     the    different 

Types! — The  swollen  parts  assume  a  black  colour  in 
the  VsLfcaja  type  and  are  felt  rough  and  uneven  to  the 
touch.  A  sort  of  spasmodic  pain  without  any  apparent 
reason  is  felt  (at  intervals  in  the  seat  of  the  disease), 
which  largely  begins  to  crack  or  burst.  The  Pittaja 
type  is  characterised  by  a  little  softness  and  yellowish 
hue  (of  the  diseased  localities)  and  often  attended  with 
fever,  and  a  burning  sensation.  In  the  Kaphaja  type  the 
affected  localities  become  white,  glossy,  slightly  painful, 
heavy,  contain  large  nodules  (Granthis)  and  are  studded 
over  with  crops  of  papillae.     16. 

Prognosis  : — A  case  of  elephantiasis  of  a  year's 
growth  as  well  as  the  one  which  is  characterised  by 
excessive  swelling  (of  the  affected  parts),  exudation  and 
vegetation  of  knotty  excrescences  resembling  the  sum- 
mits of  an  ant-hill  should  be  given  up  as  incur- 
able.    17. 

Memorable  Verses  :  -A   preponderance  of 

the  deranged  Kapham  marks  the  three  types  of  the 
disease,  in  as  much  as,  the  heaviness  and  largeness  (of 
the  swelling)  can  not  be  brought  about  by  any  other 
factor  than  Kapham.  The  disease  is  peculiar  to  countries 


84  THE  SUSHRUTA  SAMHITA.  [Chap.  XII. 

in  which  large  quantities  of  old  rain-water  remain 
stagnant  during  the  greater  part  (lit.-  all  seasons) 
of  the  year  making  them  damp  and  humid  in  all 
seasons.     18-91 

The  disease  is  usually  found  to  be  confined  to  the  legs 
and  hands  of  men  but  cases  are  on  record  in  which  it 
has  extended  to  the  ear,  nose,  lips  and  the  regions  of  the 
eyes.     (Penis — Mddhaba-Niddnam).     20. 

Thus  ends  the  twelfth  Chapter  of  ihe  Nidanasthanam  in  the  Sus'ruta 
Samhifa  which  treats  of  the  Nidanara  of  scrotal  tumours,  hernia,  Upa- 
dans'am  and  elephantiasis. 


CHAPTER  Xm. 

Now  we  shall  discourse  on  the  Nidanam  of 
Kshudrarog'am  (diseases  which  are  known  by 
the  general  name  of  minor  ailments),     i. 

These  diseases  are  generally  divided  into  forty- 
four  distinct  varieties  or  types  such  as  :  — Ajagallikji, 
Yavaprakshya,  Andhdlaji,  Vivrit^,  Kachchapika, 
Valmika,  Indravriddhd,  Panasikd,  Pashdna-garddabha, 
Jala-garddabha,  Kakshd,  Vishphota,  Agni-rohini, 
Chippam,  Kunakha,  Anusaye,  Viddrikd,  Sarkard- 
Arbudam,  Pam^,  Vicharchikd,  Rakasa,  Pddadarikd, 
Kadara,  Alasa,  Indralupta,  Darunaka,  Arunshika, 
Palitam,  Mas'urika,  Yauvana-pidaka,  Padmini-kantaka, 
Yatumani,  Mas'aka,  Charmakila,Tilakdlaka,  Nyachchya, 
Vyanga,  Parivartiki,  Avapatikd,  Niruddha-prakas'a, 
Niruddha-guda,  Ahiputanam,  Vrishana-kachchu,  and 
Guda-bhrans'a .  *     2. 

Metrical  Texts  : — The  species  of  pimples  or 
eruptions  which  are  shaped  like  the  Mud^a  pulse  and 
are  glossy,  knotty  and  painless  is  called  Ajagallikai. 
They  are  of  the  same  colour  (as  the  surrounding 
skin)  and  their  origin  is  usually  ascribed  to  the  action 
of  the  deranged  Kapham  and  Vayu.  The  disease  is 
peculiar  to  infants.f    Ya^vaiprakshyai :— The   eruptions 

*  Brahmadeva  comprising  Garddavika^  Irvellika,  Gandhapidikd  and 
Tilakdlaka  in  the  list  reads  it  as  consisting  of  thirty-four  different  species. 
Jejjata  does  not  hold  the  four  forms  of  disease  commencing  with  Gardda- 
vika,  etc,  as  inchided  within  the  list.  Gaydd^sa,  finding  them  included  in 
all  the  recensions  reads  Garddabhikd,  etc.  as  included  within -the  list  of 
Kshudra  Roga,  and  Pama  etc.  as  included  within  the  list  of  Kshudra 
Kushtham. 

t  They  afflict  certain  infants— Dallana. 


86  THE   SUSHRUTA   SAMHITA.  CCh»p.  XIII. 

which  are  shaped  like  the  barley-corns,  extremely  hard, 
thick  at  the  middle,  knotty  and  affect  (lit— confined  to) 
the  flesh  are  called  Yavaprakshya.  They  are  due  to  the 
action  of  the  deranged  Vayu  and  Kapham.  Andhail  ji : 
— The  dense,  raised,  slender-topped  eruptions  which 
appear  in  circular  patches  and  exude  a  slight  pus 
are  called  Andhdlaji.  They  are  due  to  the  action  of 
the  deranged  Vdyu  and  Kapham.  VivritSfc:  — Pustules 
or  eruptions,  which  are  coloured  like  a  ripe  fig.  fruit  and 
are  flat-topped  and  appear  in  circular  patches  with  an 
intolerable  burning  sensation,  are  called  Vivrita  They 
are  due  to  the  action  of  the  deranged  Pittam.     3  -  6. 

Kachchapika  :— A  group  of  five  or  six  hard, 
elevated,  nodular  eruptions  (Granthis),  arranged  in  the 
shape  of  a  tortoise  (which  may  appear  on  the  sur- 
face of  any  part  of  the  body),  are  called  Kachchapikd. 
They  are  due  to  the  action  of  the  deranged  Kapham 
and  V4yu.  Valmika  :  —The  knotty  undurated  erup- 
tions (Granthis)  which  gradually  appear  on  the  soles, 
palms,  joints,  neck  and  on  the  regions  above  clavicles 
and  resemble  an  ant-hill  in  shape,  slowly  gaining  in  size 
are  called  Valmika  Ulcers  attended  with  pricking 
pain,  burning,  itching  sensations  and  exuding  mucopu- 
rulent discharges  appear  around  the  aforesaid  eruptions 
(Granthis).  The  disease  is  due  to  the  action  of  the 
deranged  Kapham,  Pittam  and  Viyu.    7 — 8. 

Indravriddhst : -Pimples  or  eruptions  ^Pidakd) 
arising  (on  the  surface  of  the  body),  arranged  in  the  same 
circular  array  as  marks  the  distribution  of  the  seed  (sacks) 
in  a  lotus  flower  are  called  Indravriddha'  by  the 
physicians.  The  disease  is  caused  by  the  action  of  the 
deranged  Vdyu  and  Pittam.  Pauasika  :  — Eruptions 
(Pidakd)  of  a  sort  of  extremely  painful  pustules  all 
over     the    back     or     the     ears     which     resemble     the 


Chap.  XIII.]  NIDANA  STHANAM.  87 

Kumuda  bulb  in  shape,  are  called  Panasikat.  They 
are  due  to  the  action  of  the  deranged  Kapham  and 
Wkyu.  i:  a^sha^na-Garddabha  :— A  slightly  painful  and 
non-shifting  hard  swelling,  which  appears  on  the  joint 
of  the  jawbones,  (Hanu-sandhi,  is  called  Pashdna- 
Garddabha.  The  disease  is  the  effect  of  the  deranged 
Kapham  and  Vdyu.  Jaila-Garddabha  : — A  thin  and 
superficial  swelling,  which  like  erysipelas  is  of  a 
shifting  or  progressive  character  and  is  further  attended 
with  fever  and  a  burning  sensation  and  which  is  but 
rarely  found  to  suppurate,  is  called  Jdla-Garddabha* 
The  disease  results  from  the  deranged  Pittam. 
Kakshai  • — The  disease  characterised  by  the  eruptions  of 
black  and  painful  vesicles  i^ShphotaJ  on  the  back,  sides, 
and  on  the  region  about  the  arm-pits,  is  called  Kaksha. 
The  disease  is  likewise  attributed  to  the  action  of  the 
aggravated  Pittam,  Vishphotaka  — The  disease  in 
which  eruptions  of  burnlike  vesicles  (Shphota)  crop  up 
on  the  whole  surface  of  the  body,  or  on  that  of  any 
particular  locality,  attended  with  fever,  is  called  Vish- 
photaka.  The  disease  is  the  effect  of  vitiated  blood 
and  Pittam.     9 — 14. 

Agni-Rohinif  ;— Vesicles  (Shphota)  having  the 
appearance  of  burns  and    cropping    up  about   the   waist 

*  The  circular  raised  spots  studded  with  vesicles  are  called  Gardda- 
bhil.  They  are  reddish  and  painful  and  produced  by  the  action  of  Vayu 
and  Pittam.     Gayadasa  reads  it  so. 

t  Dallana  quotes  from  another  Tantram  that  the  morbific  principles 
in  men,  aggravated  through  the  action  of  the  enraged  and  augmented 
Pittam  and  blood,  give  rise  to  vesicles  (blisters)  like  red-hot  charcoal  by 
breaking  open  the  flesh  at  the  waist,  attended  with  txtreme  pain,  high 
fever  and  an  insufferable:  burning  sensation  which,if  not  properly  remedied, 
bring  on  dtath  wiihin  a  fortnight,  or  ten  days  of  their  first  appearance. 
These  (vesicles)  are  called  Vahni- Rohini.  And  again  from  another  work 
he  cites  that  a  case  of  Vahm-Rohini  due  to   the   aciipn    of  the   deranged 


88  THE  SUSHRUTA  SAMHITA.  [Chap.  XIII. 

(Kakshd)  by  bursting  the  local  flesh,  and  which 
is  attended  with  fever  and  a  sensation  as  if  a  blazing 
fire  is  burning  in  the  inside  (of  the  affected  part),  are 
called  Agni-Rohini.  The  disease  is  caused  by  the 
concerted  action  of  the  three  deranged  Doshas  (Vayu, 
Pittam  and  Kapham).  It  is  incurable  and  ends  in  the 
death  of  the  patient  either  on  the  seventh*,  tenth  or 
fifteenth  day  (of  its  first  appearance).     15. 

Chippam  : — The  deranged  Vdyu  and  Pittam 
vitiating  the  flesh  of  the  finger-nails,  give  rise  to  a 
disease  which  is  characterised  by  pain,  burning  and 
suppuration.  The  disease  called  Chippam,  is  also 
denominated  Upanakha  and  Kshataroga.  Kuna- 
kham  : — The  nails  of  fingers  becoming  rough,  dry, 
black,  and  injured  through  the  action  of  the  Doshas 
enraged  through  the  effect  of  a  blow,  are  called  Kunakha 
(bad  nails).  It  is  also  called  Kulinam.  Anusayi  : — 
A  small  swelling  (on  the  surface  of  the  body)  which  is 
of  the  same  colour  (as  the  surrounding  skin),  but  is 
deep-seated,  and  suppurates  in  its  deeper  strata,  is  called 
Anusayi  by  the  physicians.  The  disease  is  the  effect 
of  the  deranged  Kapham.  Vida(rika(  :— A  round  reddish 
swelling  rising  either  on  the  auxiliary  or  inguinal  regions 
in  the  shape  of  a  gourd  ( Viddrikandd)  is  known  as 
Viddrika.  The  disease  is  due  to  the  concerted  action 
of  the  deranged  Vayu,  Pittam  and  Kapham  and 
is  characterised  by  symptoms  peculiar  to  each  of 
them.     16—19, 


Kapham  proves  fatal  within  »  fortnight,  that  due  to  the  deranged  Pittam, 
within  ten  days,  and  that  due  to  the  deranged  Vayu,  within  a  week. 

*  The  patient  dies  on  the  seventh  day  in  a  case  of  disease  marked  by 
the  dominant  Vayu,  on  the  tenth  day  in  a  case  marked  by  the  dominant 
Pittam  and  on  the  fifteenth  day  in  a  case  of  dominant  deranged  Kapham. 


Chap.  XIII.]  NIDANA  STHANAM.  89 

^arkararbudam  :— The  deranged  Vayu  and 
Kapham  having  recourse  to  and  affecting  the  flesh,  veins 
(S'ira),  ligaments  (Snayu)  and  fat  give  rise  to  a  sort  of 
cyst  (Granthi)  which  when  it  bursts  exudes  a  copious 
secretion  in  its  nature  somewhat  like  honey,  clarified 
butter  or  Vasa.  The  aforesaid  V^yu,  when  aggravated 
through  excessive  secretion,  dries  and  gathers  the  flesh 
up  again  in  the  shape  of  (a  large  number  of)  gravel-like 
concretions  (Sarkara)  known  accordingly  as  Sarkardrbu- 
dam.  A  fetid  secretion  of  varied  colour  is  secreted  from 
the  veins  (Sira)  in  these  Granthis  which  are  sometimes 
found  to  bleed  suddenly.  The  three  varieties  of  the  skin 
disease  called  Psbinat  (Eczema),  Vicharchikai  (Psoriasis) 
and  Rakasat  have  already  been  discussed  under  the  head 
of  Kushtham  (Chapter.  V.).     20-21. 

Padadarika  :— The  soles  and  feet  of  a  person 
of  extremely  pedestrian  habits  become  dry  (and  lose 
their  natural  serous  moisture).  The  local  Vayu  thus 
aggravated  gives  rise  to  peculiar  painful  cracks 
(Dari  in  the  affected  parts)  which  are  called  Pada- 
darika. Kadara  : — The  knotty  (Granthi),  a  painful, 
hard  growth  raised  at  the  middle  or  sunk  at  the  sides, 
which  exudes  a  secretion  and  resembles  an  Indian 
plum  (Kola— in  shape),  and  appearing  at  the  soles 
(palms  according  to — Bhoja)  of  a  person  as  an  outcome 
of  the  vitiated  condition  of  the  local  blood  and  fat 
produced  by  the  deranged  Doshas  incidental  to  the 
pricking  of  a  thorn  etc.  or  of  gravel  is  called  a  Kadara 
(corns).  Alasa  : — An  affection,  caused  by  contact  of 
poisonous  mire  and  appearing  between  the  toes,  which 
is  characterised  by  pains,  burningj«  itching  and  exuda- 
tion, is  called  Alasa.     22 — 25. 

Indralupta:--The  deranged  Vayu  and  Pittam 
having  recourse  to  the  roots  of  the  hairs  bring  about  their 

12 


^O  THE  SUSHRUtA  SAMHITA.  [Chap.  XIll. 

gradual  falling  off,  while  the  deranged  blood  and 
Kapham  of  the  locality  fill  up  those  pores  or  holes,  thus 
barring  their  fresh  growth  and  recrudescence.  The 
disease  is  called  Indralupta,*  Rujya  or  Khailitya  (Alo- 
pecia). Dairunaka: — The  disease  in  which  the  hairy 
parts  of  the  body  (roots  of  hairs)  become  hard,  dry  and 
characterised  by  an  itching  sensation  is  called  Daru- 
naka.  The  disease  is  due  to  the  action  of  the  deranged 
Kapham  and  Vdyu.  Arunshikat : — Ulcers  (A runshi)  at- 
tended with  mucopurulent  discharges  and  furnished  with 
a  number  of  mouths  or  outlets  and  appearing  on  the 
scalps  of  men  as  the  result  of  the  action  of  local 
parasites  and  of  the  deranged  blood  and  Kapham  (of 
the  locality)  are  called  Arunshika.  Palitam  : — The 
heat  and  Pittam  of  the  body  having  recourse  to  the 
region  of  the  head  owing  to  overwork,  fatigue,  and  ex- 
cessive grief  or  anger,  tend  to  make  the  hair  prema- 
turely grey,  and  such  silvering  of  the  hair  (before  the 
natural  period  of  senile  decay)  is  called  Palitam. 
Masuriksi  (variola) : — The  yellow  or  copper-coloured 
pustules  or  eruptions  attended  with  pain,  fever  and  burn- 
ing and  appearing  all  over  the  body,  on  (the  skin  of)  the 
face  and  inside  the  cavity  of  the  mouth,  are  called 
Masurikd.  Yauvana-pidakat— (Mukhadushikai)  :~The 
pimples  like  the  thorns  of  a  Salmali  tree,  which  arefound 
on  the  face  of  young  men  through  the  deranged  condition 
of  the  blood,  Vdyu  and  Kapham,  are  called  Yauvana- 
pidaki  or  pimples  of  youth.  Padmini-Kantaka  : 
— The  circular,  greyish  patches   or   rash-like   eruptions 

*  Women  are  generally  proof  against  this  disease  owing  to  their 
delicate  constitution  and  to  their  being  subjected  to  the  monthly  discharge 
of  vitiated  blood  and  at  the  same  time  to  their  undergoing  no  physical 
exercise,  and  hence  there  is  little  chance  of  the  bodily  Pittam  being 
deranged  and  bringing  on  this  disease. 


Chap.  XIII.]  NIDANA  STHANAM.  9I 

Studded  over  with  thorny  papilla  of  the  skin  resembling 
the  thorns  on  the  stem  of  the  lotus  marked  by  itching 
are  called  Padmini-kantaka.  The  disease  is  due  to  the 
deranged  condition  of  the  Vdyu  and  Kapham.  Yatu- 
mani  (mole)  : — The  reddish,  glossy,  circular,  and  pain- 
less, congenital  marks  (Sahajam)  or  moles  on  the  body  not 
more  elevated  (than  the  surrounding  skin)  are  called 
Yatumani.  The  disease  is  due  to  the  deranged  condition 
of  the  blood  and  Pittam.     26—33. 

IVIasaka  (Lichen)  :  —The  hard,  painless, 
black  and  elevated  eruptions  on  the  body  (skin)  re- 
sembling the  Mdsha  pulse  in  shape,  caused  by  the 
aggravated  condition  of  the  bodily  Vayu  are  called 
Mas'aka  Tilakalaka: — The  black  painless  spots  on 
the  skin  about  the  size  of  a  sesamum  seed  and 
level  with  the  skin  are  called  Tilakalaka.  This 
disease  is  caused  through  the  aggravated  condition  of 
the  Vayu,  Pittam  and  Kapham  .f  Nyachcham: — The 
congenital,  painless,  circular,  white  or  brown  (Sydva) 
patches  on  the  skin,  which  are  found  to  be  restricted 
to  a  small  or  comparatively  diffused  area  of  the  skin, 
are  called  Nyachcham.  Charmakila  (hypertrophy  of 
the  skin)  : — The  causes  and  symptoms  of  the  disease 
known  as  Charmakila  have  been  already  described 
(under  the  head  of  the  Ars'a-Nidanam).  Vyanga  : — 
The  Vayu  being  aggravated  through  wrath  and  over- 
fatiguing  physical  exercise,  and  surcharged  with  Pittam, 
and  suddenly  appearing  on  the  face  of  a  person,  causes 
thin,  circular,  painless  and  brown-coloured  patches  or 
stains.  They  are  known  by  the  name  of  Vyanga  *    34-38. 

*  According  to  certain  authorities  it  is  due  to  the  absorption  of  blood 
by  Vayu  and  Pittam. 

+  According  to  others  the  spot  goes  by  the  name  of  Nilikam^  if  it 
is  black-coloured  and  appears  anywhere  other  than  on  the  face* 


92  THE  SUSHRUTA  SAMHITA.  [Chap.  XIII. 

The  Parivartika  :— The  vital  Vayu  (Vydna) 
aggravated  by  such  causes  as  excessive  massage  (mastur- 
bation), pressure,  or  local  trauma,  attacks  the  integuments 
of  the  penis  (prepuce)  which  being  thus  affected  by 
the  deranged  Vayu  forms  into  a  knot-like  structure  and 
hangs  down  from  the  glans  penis.  The  disease  known 
as  Parivartika  or  Phymosis  is  due  to  the  action  of  the 
deranged  Vayu  aggravated  by  any  extraneous  factor. 
It  is  marked  by  pain  and  burning  sensation;  and  some- 
times suppurates.  When  the  knotty  growth  becomes 
hard  and  is  accompanied  by  itching,  then  it  is  caused  by 
the  aggravated  Kapham.     39. 

Avapatika  :~When  the  integuments  of  the 
prepuce  is  abnormally  and  forcibly  turned  back  by  such 
causes  as  coition  under  excitement,  with  a  girl  ^before 
menstruation  and  before  the  rupture  of  the  hymen  and 
consequently  with  a  narrow  external  orifice  of  the  vagina) 
or  masturbation  or  pressure  or  a  blow  on  the  penis, 
or  a  voluntary  retention  o{  a  flow  of  semen  or  forcible 
opening  of  the  prepuce,  the  disease  is  called  Avapdtikd 
or  paraphymosis.  Niruddha-prakatsa :— -The  prepuce 
affected  by  the  deranged  Vayu  entirely  covers  up  the 
glans  penis  and  thus  obstructs  and  covers  up  the  orifice 
of  the  urethra.  In  cases  of  partial  obstruction  a  thin 
jet  of  urine  is  emitted  with  a  slight  pain.  In  cases 
of  complete  closing  the  emission  of  urine  is  stopped 
without  causing  any  crack  or  fissure  in  the  glans  penis 
in  consequence.  The  disease  is  called  Niruddha-prakds a 
which  is  due  to  the  deranged  Vayu  and  is  marked  by 
pain  (in  the  glans  penis\     39-41. 

Niruddhaguda  :-The  Vayu (Apana) obstruct- 
ed by  the  repression  of  a  natural  urging  towards  de- 
fecation stuffs  the  rectum,  thus  producing  constriction 
of    its   passage    and    consequent    difficulty    of    defeca- 


Chap.  XIII.]  NIDANA   STHANAM.  93 

tion.  This  dreadful  disease  is  known  as  Niruddha- 
gudam  (stricture  of  the  rectum)  which  is  extremely 
difficult  to  cure.  Ahiputana : — A  sort  of  itch-like 
eruptions  appearing  about  the  anus  of  a  child  owing 
to  a  deposit  of  urine,  perspiration,  feces  etc  conse- 
quent on  the  neglect  in  cleansing  that  part.  The 
eruptions  which  are  the  effects  of  the  deranged  blood 
and  Kapham  soon  assume  an  Eczematous  character 
and  exude  a  purulent  discharge  on  account  of  constant 
scratching.  The  Eczema  (Vrana;  soon  spreads,  and 
coalesces  and  proves  very  obstinate  in  the  end.  The 
disease  is  called  Ahiputana.  Vrishana-kachchu : — When 
the  filthy  matter,  deposited  in  the  scrotal  integuments 
of  a  person  who  is  negligent  in  washing  the  parts  or 
in  the  habit  of  taking  daily  ablutions,  is  moistend 
by  the  local  perspiration,  it  gives  rise  to  an  itching 
sensation  in  the  skin  of  the  scrotum,  which  is  speedily 
turned  into  running  Eczema  by  constant  scratching 
of  the  parts.  The  disease  is  called  Vrishana-kachchu 
and  is  due  to  the  aggravated  condition  of  the  Kapham 
and  blood.  Guda-Bhransa  : — A  prolapse  or  falling  out 
of  the  anus  (due  to  the  Vayu)  in  a  weak  and  lean  patient 
through  straining,  urging  or  flow  of  stool  as  in  dysentery 
is  called  Guda-Bhransa  or  prolapsus  ani.     42 — 45. 

Thus  ends   the   thirteenth   Chapter   of  the   Nidana   Sthanam   in   the 
Sus'ruta  Samhita  which  treats  of  the  Nidanam  of  minor  ailments. 


CHAPTER   XIV. 

Now  we  shall  discourse  on  the  Nidanam  of  the 
disease  known  as  SukadOSha.      i. 

Any  of  the  eighteen  different  types  of  the  disease 
may  affect  the  genital  (penis)  of  a  man  who  foolishly 
resorts  to  the  practice  of  getting  it  abnormally  elongated 
and  swollen  by  plastering  it  with  Suka  (a  kind  of 
irritating  water  insect)  and  not  in  the  usual  officinal  way. 

Classification  : — Diseases,  which  result  from 
such  malpractices,  are  knonwn  as, — Sarshapika,  Ashthi- 
lika,  Grathitam,  Kumbhika,  Alaji,  Mriditam,  Sammudha- 
pidaka,  Avamantha,  Pushkarika,  Spars'ahani,  Uttama, 
Satoponaka,  Tvakapaka,  Sonitarvudam,  Mansarvudam, 
Mansapaka,  Vidradhi  and  Tilakalak.     2. 

Metrical  Texts  :— The  tiny  herpetic  eruptions 
(Pidaka)  which  resemble  the  seeds  of  white  mustard  in 
shape  and  size,  (and  are  found  to  crop  up  on  the  male 
organ  of  generation)  on  account  of  a  deranged  condition 
of  the  blood  and  Kapham,  as  the  result  of  an  injudicious 
application  of  Suka  plasters  are  called  Sarshapikai 
by  the  wise.  Eruptions  of  hard  stone-like  pimples, 
(Pidaka)  irregular  at  their  sides  or  edges  and  which  are 
caused  by  the  aggravation  of  the  local  Vayu  by  the  use 
of  a  plaster  of  the  poisonous  Suka,  are  called  Ashthilika'. 
The  knotty  Granthis  (nodules)  on  the  penis  owing 
to  its  being  frequently  stuffed  with  the  bristles  of  a 
Suka  insect  are  called  Grathitam.  This  type  is  caused 
by  the  deranged  action  of  the  Kapham.  A  black  wart 
resembling  the  stone  or  seed  of  a  jambolin  fruit  in 
shape  is  called  Kumbhikai.  This  type  is  due  to  the 
deranged  condition  of  the  blood  and  Pittam.      3  —  5. 


Chap.  XIV.]  NIJDANA  STHANAM.  95 

An  Alaji  (incidental  to  an  injudicious  application 
of  Suka  on  the  penis)  exhibits  symptoms,  which  are 
identical  with  those  manifested  by  a  case  of  Alaji 
in  Prameha  (Ch.  vi).  A  wart  (papilloma)  attended 
with  swelling  of  the  part  and  caused  by  the  aggravated 
Vayu  on  the  hard  and  inflamed  penis  causing  pressure 
(on  the  urethra)  is  called  Mriditam.  The  pustule  or 
eruption  appearing  on  the  penis  on  account  of  its  being 
extremely  pressed  by  the  hand  i^for  the  insertion  of  the 
hairs  of  the  Suka)  in  its  dorsum  is  called  Sammudha- 
pidaka^.  (It  is  the  outcome  of  the  aggravated  Vayu*). 
A  large  number  of  elongated  pustules  on  the  penis  (in- 
cidental to  an  application  of  Suka  to  the  part)  which 
burst  at  the  middle,  causing  pain  and  shivering,  is  called 
Avamantha  (epithelioma ^     6  —  10. 

The  Pushkarika  type  of  the  disease  is  marked 
by  the  eruptions  of  small  pimples  around  the  principal 
one  The  type  has  its  origin  in  the  deranged  condition 
of  the  blood  and  Pittam,  and  is  so  called  from  the  part 
of  the  excrescenses  being  arranged  in  rings  or  circles  like 
the  petals  of  a  lotus  flower  in  shape.  A  complete  anes- 
thesia (of  the  affected  organ)  owing  to  the  vitiated  blood 
by  the  injudicious  application  of  a  Suka  is  called  Spars'a- 
haini.  Pustules  appearing  on  the  penis  through  the 
vitiation  of  the  local  blood  and  Pittam  by  such  con- 
stant applications  are  called  Uttamsi.  A  suppuration  of 
the  prepuce  under  the  circumstance  is  called  Tvakapaikh. 
There  is  fever  with  a  burning  sensation  in  the  affected 
organ.  The  disease  is  due  to  the  vitiated  condition 
of  the  blood  and  Pittam.     11-— 15. 

The  type  of  the  disease  in  which  the  penis  is  marked 
by  the  eruption  of  black  vesicles  and  is  covered  over 
with   a    large   number   of   red    pimples  or  pustules  with 

According  to  Dallana  it  is  due  to  the  action  of  Vayu  and  blood. 


g6  THE   SUSHRUTA  SAMHITA.  tChap.  XIV. 

an  excruciating  pain  in  the  ulcerated  region  of  the  organ 
IS  called  Sonitafcrvudam.  The  vegetation  of  a  fleshy- 
tumour  on  the  penis  (incidental  to  a  blow  on  the  organ 
to  alleviate  the  pain  of  inserting  the  hairs  of  the  Suka 
insect  into  its  body),  is  called  MsinsaLrvudam.  A  sup- 
puration as  well  as  sloughing  of  the  penis  attended  with 
different  kinds  of  pain  which  severally  mark  the  de- 
ranged Vayu,  Pittam  and  Kapham  is  called  Ma'nsa- 
paHia.  This  type  is  caused  by  the  concerted  action 
of  the  deranged  Vayu,  Pittam  and  Kapham.     15-18. 

The  specific  symptoms  of  a  Tridoshaja  Vidradhi 
as  described  before  (Chap.ix.)  mark  the  one  which  affects 
the  penis  (owing  to  an  injudicious  application  of  the 
highly  poisonous  irritant  Suka  to  the  organs)  The 
disease  is  called  Vidradhi.  A  process  of  general  sup- 
puration and  sloughing  of  the  organ  marks  the  type 
which  is  produced  by  the  application  of  a  black  Suka  or 
one  of  a  variegated  coloured  insect  of  the  same  species. 
The  type  is  called  Tilakailaka,  and  should  be  regarded 
as    Tridoshaja  one.    19-21. 

ProgTIOSiS  : — Of  the  above  enumerated  malig- 
nant diseases  of  the  penis,  those  known  as  Mansarvuda, 
Mansapaka,  Vidradhi  and  Tilakalak  shoulda  be  deemed 
as  incurable.     22. 

Thus  ends   the   fourteenth  Chapter     of  the  Nidana     Sthanam    in   the 
Sus'ruta  Samhita  which  treats  of  Nidanam  of  different  types  of  S'ukadohsa. 


CHAPTER  XV. 

Now  we  shall  discourse  on  the  Nidanam  of  Bhagf-^ 
na.m  (fractures  and  dislocations  etc.  of  bones),     i 

Various  kinds  of  fracture  may  be  caused  from  a 
variety  of  causes,  such  as  by  a  fall,  pressure,  blow, 
violent  jerking  or  by  the  bites  of  ferocious  beasts  etc. 
These  cases  may  be  grouped  under  the  two  main  sub- 
divisions such  as.  Sandhi-Muktam  (dislocation)  and 
Ka^nda-Bhagnam  (fracture  of  a  kanda).     2. 

Cases  of  Sandhi-muktam  (dislocation)  may  be  divided 
into  six  different  types,  such  as  the  Utplishtam,  Visf- 
lishtanty  Vivartitam,  Adhak-Kshiptam,  Ati-kshiptam  and 
Tiryak-kshiptam.     3 . 

General  features  of  a  dislocation  :^ 

Incapability  of  extension,  flexion,  movement,  circum- 
duction and  rotation  (immobility,  considered  in  respect 
of  the  natural  movements  of  the  joint),  of  the  dislocated 
limb,  which  becomes  extremely  painful  and  cannot 
bear  the  least  touch.  These  are  said  to  be  the  general 
symptoms  of  a  dislocation.     4. 

Diagnostic  symptoms  of  a  disloca- 
tion : — 'In  case  of  a  friction  of  a  joint  by  two  articular 
extremeties  (Utplishtam)  a  swelling  is  found  to  appear 
on  either  side  of  the  articulation  attended  with  a  variety 
of  pain  at  night.  A  little  swelling  accompanied  by 
a  constant  pain  and  disordered  function  of  the  dislocated 
joint,  marks  the  case  of  simple-looseness  (Vislishtam) 
of  the  articulation  ;  while  pain  and  unevenness  of  the 
joint  owing  to  the  displacement  of  the  connected  bones 
distinguish  a  case  of  Vivartitam  (lateral  displacement). 
An  excruciating  pain,  and    looseness    of  the   dislocated 

13 


98  THE  SUSHRUTA  SAMHITA.  [Chap.  XV. 

bone  are  the  symptoms  which  characterise  a  case  in 
which  a  dislodged  bone  is  seen  to  drop  or  hang  down 
from  its  joint  (Adhah-kshiptam).  In  a  case  of  abnor- 
mal projection  (Ati-kshiptam),  the  dislocated  bone  is 
removed  away  from  its  joint  which  becomes  extremely 
painful.  A  case  of  oblique  dislocation  (Tiryak-kshiptam) 
is  marked  by  the  projection  or  displacement  of  the 
bone  on  one  side  accompanied  by  a  sort  of  intolerable 
pain.     5. 

Different    kinds     of    Ksinda    Bhag- 

nam  : — Now  we  shall  describe  the  Kanda-Bhagnam 
(fracture  etc.).  Fractures  may  be  divided  into  twelve 
different  kinds  which  are  known  as,  Karkatakam,  AsVa- 
karnam,Churnitam,Pichchitam,Asthi-chchalitam,Kanda- 
bhagnam,  Majjagatam,  Atipdtitam,  Vakram,  Chchinnam, 
Pdtitam  and  Sphutitam.     6. 

General  symptoms  of  K^nda-bhag- 

nam  :  —  A  violent  swelling  (about  the  seat  of  fracture) 
with  throbbings  or  pulsations,  abnormality  in  the  position 
(of  the  fractured  limb),  which  cannot  bear  the  least 
touch,  crepitus  under  pressure,  a  looseness  or  dropping  of 
the  limb,  the  presence  of  a  variety  of  pain  and  a  sense  of 
discomfort  in  all  positions  are  the  indications  which 
generally  mark  all  kinds  of  fracture  (Kanda-bhagnam).  7. 
Diagnostic  symptoms:— The  case  where  a 
fractured  bone,  pressed  or  bent  down  at  its  two  articular 
extremities,  bulges  out  at  the  middle  so  as  to  resemble 
the  shape  of  a  knot  (Granthi),  is  called  Karkatam. 
The  case  where  the  fractured  bone  projects  upward 
like  the  ear  of  a  horse  is  called  AsVakamam.  The 
fractured  bone  is  found  to  be  shattered  into  fragments 
in  a  case  of  the  Churnitam  or  comminuted  kind  which 
can  be  detected  both  by  palpation  and  crepitation. 
A  smashed   condition    of  the   fractured   bone   marks   a 


Chap.  XV.]  NIDANA  STHANAM.  99 

case   of  the  Pichcliitain  kind   which   is    often   found  to 
be    marked   by   a   great   swelling.     The    case  where  the 
covering  or  skin   of  the   bone    (periosteum)   is   cast    or 
splintered   off   is    called    the    Asthi-chchallitam.     The 
case  where  the  completely  broken  or    severed    bones  are 
found  to  project  through  the  local  skin,  is  called  Katada- 
bhagnatn  (compound).     The   case  where  a  fragment   of 
the   fractured   or   broken  bone  is  found  to  pierce  into  the 
bone  and  dig  out  the  marrow,    is  called  Majjsiaugatain, 
(Impacted  fracture).     The  case  where  the  fractured  bone 
droops  or  hangs  down  is   called  Ati-paititani.     The  case 
where  the  unloosened  bone   (from    its   position)    is    bent 
down  in   the  form   of  an  arch  is  called  Vakram      The 
case  where  only  one  articular  extremity   of  the    bone  is 
severed   is  called  Chhinnaoi.     The  case  where  the  bone 
is  slightly  fractured  and  pierced  with   a   large   number 
of  holes,   is    called  PaLtitam,  an  excruciating  pain  being 
the  leading  indication.     The  case  where  the  bone  largely 
cracked  and  swollen  becomes  painful   as    if  stuffed  with 
the  bristles  of  a  Suka  insect  is  called  Sphutitam  (Green- 
stick  fracture).     Of  the   several  kinds  of  fracture,   cures 
are  effected   with  extreme   difficulty  in    a    case    of  the 
Churnitam,  Chhinnam,    Ati-patitam     or    Majjanugatam 
kind.     A  case   of  displacement    or   laxation    occurring 
in  a   child  or  in  an  old  or  weak  patient  or  in  one  suffer- 
ing  from    asthma   (Svasa)  or  from  any  cutaneous  affec- 
tion (Kushtha)  or  Kshata-Kshina    disease  is  difficult   to 
cure.     8. 

Memorable  verses  :  —The  following   cases 

are  to  bs  given  up  as  hopeless —z^/s.  fracture  of  the 
pelvic  bone  (or  of  bones  that  are  of  this  description, 
wherever  they  may  be  situated) ;  dislocation  of  the 
pelvic  joints  ;  compound  fracture  of  the  thigh  bone  or 
of  the  flat  bones)  ;   fracture   into    small    pieces  of  the 


lOO  THE  SUSHRUTA  SAMHITA.  [Chap.  XV. 

frontal  bone  or  its  dislocation  ;  simple  fracture  of  the 
breast-bones,  back-bone  and  temporal  and  cranial  bones. 
If  the  dislocations  and  fractures  be  improperly  set 
from  the  outset  (Adito)*  or  if  the  union  be  anyhow 
disturbed  there  is  no  hope  for  recovery.     9 — 11. 

If  fractures  happen  at  any  time  of  the  first  three 
stages  of  adalt  life  which  has  been  described  before 
(vide  Sutrasthana  Chap,  XXXV.)  and  if  they  are  set  up 
by  an  able  surgeon  they  have  a  great  chance  of  being 
united.     12. 

A  bending  of  a  gristle  or  cartilage  (Taruna)  is 
called  its  fracture.  A  Nalaka  (long  bone)  bone  is 
usually  found  to  be  severed.  A  Kapatla  bone  is  found 
to  be  cracked,  while  a  Ruchakaf  (tooth)  is  found  to  be 
splintered  off.     13. 

*     The  word  Adiio  may  be  taicen    into    the  sense   of  congenital  mal- 
formation which  is  beyond  remedy. 

+    The  presence  of  the  particle  'cha'  denotes  Valya-asthi- 

Thus  ends  the  fifteenth  Chapter  of  the  Nidana  Sthanam  in  the  Sus'ruta 
amhit^  which  treats  of  the   Nidanam  of   dislocations  and  fractures. 


CHAPTER  XVI. 

Now  we  shall  discourse  on  the  Nidanam  of 
lYl  Uk ha. Tog's. m  (diseases  which  affect  the  cavity  of 
the  mouth  in  general),     i. 

General  Classifications:— Sixty  five*  dif- 
ferent forms  of  mouth  disease  are  known  in  practice. 
They  are  found  to  attack  seven  different  localities  viz. 
the  lips,  the  gums  of  the  teeth,  tongue,  palate,  throat  and 
the  entire  cavity  ;  of  these  eight  are  peculiar  to  the  lips  ; 
fifteen,  to  the  roots  of  the  teeth;  eight  to  the  teeth; 
five  to  the  tongue  ;  nine  to  the  palate  ;  seventeen  to 
the  throat;  and  three  to  the  entire  cavity.     2 — 3. 

Diseases  of  the  lips  :— The  eight  forms  which 
affect  the  lips,  are  either  Vataja,  Pittaja,  Kaphaja,  Sanni- 
pdtika,  Raktaja,  M^ns'aja,  Medaja  or  Abhighdtaja 
(Traumatic).     4. 

The  Vsitaja  Type:— The  lips  become  dry, 
rough, numbed,  black,  extremely  painful  and  the  affected 
part  seems  as  if  it  were  smashed  and  pulled  out  or 
cracked  by  the  action  of  the  aggravated  Va(yu.  In  the 
Pittaja  type — the  lips  become  blue  or  yellow-coloured 
and  studded  with  (a  large  number  of  small)  mustard- 
seed-like  eruptions,  which  suppurate  and  exude  a  puru- 
lent discharge  attended  with  a  burning  sensation  (in 
the  locality).  In  the  Kaphaja  type — the  affected  lips 
are  covered  with  small  eruptions,  which  are  of  the  same 
colour  as  the  surrounding  part,  and  become  slimy,  heavy 
or  thick,  cold  and  swollen.  Pain  is  absent  in  this  type 
and  the  patient  feels  an  irresistible  inclination  to  scratch 
the  parts.     In  the  Satnnipaitaja  type,  the   lips  change 

*  According  to  others  sixty-seven-^but  Dalian  does  not  support  this. 


102  THE  SUSHRUTA  SAMHITA.  [Chap.  XVI. 

colour,  becoming  black,  yellow,  or  ash-coloured  (white) 
at  intervals  and  are  found  to  be  studded  with  various 
sorts  of  eruptions.     5 — 8. 

The  Raktaja  type :— (Produced  by  the  vitiated 
condition  of  the  blood)  the  affected  lips  look  as  red  as 
blood  and  profusely  bleed  and  crops  of  date  coloured 
(chocolate-coloured)  eruptions  appear  on  their  surface.  In 
the  Maknsaja  type  (due  to  the  vitiated  condition  of  the 
local  flesh),  the  lips  become  heavy,  thick  and  gathered  up 
in  the  form  of  a  lump  of  flesh.  The  angles  of  the 
mouth  become  infested  with  parasites  which  germi- 
nate and  spread  themselves  in  the  affected  parts.  In 
the  Medaja(fat-origined)  type  the  lips  become  numbed, 
soft,  heavy  and  marked  by  an  itching  sensation.  The 
skin  of  the  inflamed  surface  becomes  glossy  and  looks 
like  the  surface  layer  of  clarified  butter  exuding  a  thin 
crystal-like  (transparent)  watery  discharge.  In  the 
Abhighaitaja  (Traumatic)  type,  the  lips  become  red, 
knotty  and  marked  by  an  itching  sensation  and  seem  as 
if  (pierced  into  or  cut  open  with  an  axe  and  (become 
cracked  and  fissured).    9 — 12. 

Disease  of  the  roots  of  the  teeth  ;— 

Diseases  which  are  peculiar  to  the  roots  of  the  teeth,  are 
known  as  Sitada,  Danta-pupputaka,  Danta-veshtaka, 
Saushira,  Mdha-Saushira,  Paridara,  Upakus'a,  Danta- 
vaidarbha,  Vardhana,  Adhimansa  and  the  five  sorts  -of 
Nddi  (,sinus).  13. 

Sitada  (Scurvy); — The  gums  of  the  teeth  suddenly 
bleed  and  become  putrified,  black, slimy  and  emit  a  fetid 
smell.  They  become  soft  and  gradually  slough  off. 
The  disease  has  its  origin  in  the  deranged  condition 
of  the  local  blood  and  Kapham.  Dantapupputaka 
(gum  boil): — The  disease  in  which  the  roots  of  two  or 
three  teeth  at  a  time  is  marked  by  a  violent  swelling  and 


Chtip.  XVI.]  NIDANA  STHANAM.  1 03 

pain  is  called  Danta-pupputaka.  The  disease  is  due 
to  the  vitiated  condition  of  the  blood  and  Kapham. 
Danta-veshtaka: — The  teeth  become  loose  in  the  gums, 
which  exude  a  discharge  of  blood  and  pus.  This  disease 
is  due  to  the  vitiated  blood  of  the  locality.  Saushira:— 
The  disease  in  which  an  itching  painful  swelling  appears 
about  the  gums  attended  with  copious  flow  of  saliva  is 
called  Saushira  (Alveolar  abscess).  It  is  caused  by  the 
deranged  blood  and  Kapham  of  the  locality.  Maha(- 
Saushira : — The  disease  in  which  the  teeth  become  loose, 
the  palate  marked  by  sinuses  or  fissures,  the  gums  putri- 
fied,  and  the  whole  cavity  of  the  mouth  inflamed,  is 
called  Mahas'aushira,  the  outcome  of  the  concerted  action 
of  the  deranged  Doshas  of  the  body.     14 — 18. 

Paricla.ra.  : — The  disease  in  which  the  gums  be- 
come putrified,  wear  off  and  bleed  is  called  Paridara 
(bleeding  gums\  The  disease  has  its  origin  in  the 
deranged  condition  of  the  blood,  Kapham  and  Pittam. 
Upakusa  :~The  disease  in  which  the  gums  become 
marked  by  a  burning  sensation  and  suppuration  and 
the  teeth  become  loose  and  shaky  (in  their  gums)  in 
consequence  and  bleed  at  the  least  shaking,  is  called 
Upakusa.  There  is  a  slight  pain,  and  the  entire  cavity 
of  the  mouth  becomes  swollen  and  emits  a  fetid  smell  ; 
this  disease  is  due  to  the  vitiated  condition  of  the 
blood  and  Pittam.     19. 

Danta-Vaidarbha  :— The  disease  which  is 
consequent  upon  the  friction  of  the  gums  marked  by  the 
appearance  of  a  violent  swelling  about  the  portion  (so 
rubbed  and  in  which)  the  teeth  beeome  loose  and  can  be 
moved  about,  is  called  Danta-vaidarbha  which  is  due  to 
an  extraneous  cause  such  as  a  blow  etc.  Vardhana  : — 
the  disease  which  is  marked  by  the  advent  of  an 
additional   tooth   (the   last   molar)   through  the   action 


t04  THE  SUSHRUTA  SAMHITA.  [Chap.  XVI. 

of  the  deranged  Vayu  with  a  specific  excruciating  pain 
of  its  own,  is  called  Vardhana  or  eruption  of  the  Wisdom 
tooth.  The  pain  subsides  with  the  cutting  of  the  tooth. 
Adhimainsa :— The  disease  in  which  a  violent  and 
extremely  painful  tumour  appears  about  the  root  of  the 
tooth,  and  is  situated  in  the  farthest  end  of  the  cavity  of 
the  cheek-bone  accompanied  by  a  copious  flow  of  saliva 
"is  called  Adhimansa  or  Epulis.  It  is  due  to  the 
deranged  Kapham.  The  five  sorts  of  Na'di  (sinus) 
which  affect  the  roots  of  the  teeth  (are  either  Vataja, 
Pittaja,  Kaphaja,  Sdnnipataja  or  Abhighataja),  their 
symptoms  being  respectively  identical  with  those  of  the 
types  of  Nadi-vrana.     20  —24. 

Diseases  to  the  teeth  proper :— Diseases 

which  are  restricted  to  the  teeth  proper  are  named  as, 
Ddlana,  Krimi-dantaka,  Danta-harsha,  Bhanjaka,  Sarkard, 
Kapalika,  Syiva-dantaka  and  Hanu-moksha.     25. 

Dalana  : — The  disease  in  which  the  teeth  seem 
as  if  being  cleft  asunder  with  a  violent  pain  is  called 
Deilana  or  toothache,  the  origin  of  which  is  ascribed 
to  the  action  of  the  aggravated  state  of  the  bodily  Vayu. 
Krimi-dantaka  : — The  disease  in  which  the  teeth  are 
eaten  into  by  worms,  is  called  Krimi-dantaka  (caries\ 
The  teeth  become  loose  and  perforated  by  black  holes 
accompanied  by  a  copious  flow  of  saliva.  The  appear- 
ance of  an  extremely  diffused  swelling  (about  the  roots  of 
decayed  teeth)  with  a  sudden  aggravation  of  the  accom- 
panying pain  without  any  apparent  cause  is  also  one 
of  its  specific  features.  Danta-harsha  : — The  disease 
in  which  the  teeth  cannot  bear  the  heat,  cold  or  touch  is 
called  Danta-harsha.  It  is  due  to  the  deranged  condi- 
tion of  Vdyu.  Bhanjaka  : — The  disease  in  which  the 
face  is  distorted,  the  teeth  break,  and  the  accompanying 
pain   is   severe,   is   called  Bhanjaka  (degeneration  of  the 


Chap.   XV 1  ]  NIDANA   STHANAM.  10^ 

teeth).  The  disease  is  due  to  the  deranged  condition  of 
the  Vayu  and  Kapham.  Sarkaiai  : — The  disease,  in 
which  sordes,  formed  on  the  teeth  and  hardened  (by  the 
action  of  the  deranged  Vayu),  lie  in  a  crystallised  form 
at  the  roots  of  the  teeth,  is  called  Sarkara  (Tartar). 
Such  deposits  tend  to  destroy  the  healthy  growth  and 
functions  of  the  teeth.  Kapalikai  : — The  disease  in  which 
the  preceding  crystallised  deposits  get  cemented  together 
and  afterwards  separate  from  the  teeth  taking  away  a  part 
of  their  coating  (enamel)  is  called  Kapalika  (calcareous 
deposit)  which  naturally  makes  an  erosion  into  and 
destroys  the  teeth  Sya^va-dantaka  :— The  disease,  in 
which  the  teeth  variously  scorched  by  the  action  of  the 
deranged  Pittam  assumes  a  blackish  or  blue  colour,  is 
named  as  Syava-dantaka  (black  teeth).  Hanu-moksha : — 
The  disease  in  which  the  Vayu  aggravated  (by  such 
causes,  as  by  loud  talking,  chewing  of  hard  substances, 
or  immoderate  yawning)  produces  the  dislocation  of  the 
jawbones  is  called  Hanu-moksha  It  is  identical  with 
Ardditam  as  regards  its  symptoms.     26-33. 

Diseases  of  the  tongue  :— The  five  kinds 

of  diseases    which    affect  the  organ    of    taste   are   the 

three    sorts    of    Kantakas  due    to    the    three    deranged 

Doshas  (Vataja  Pittaja  and  Kaphaja),  AUsa  and 
Upa-jihvika.     34. 

The  three  Kantaks  :— In  the  Vataja  Kan- 

taka  type  the  tongue  becomes  cracked,  loses  the 
sense  of  taste  and  becomes  rough  like  a  teak  leaf 
(giving  the  organ  a  warty  appearance).  In  the  Pittaja 
Kantaka  form  the  tongue  is  coloured  yellow  and  studded 
over  with  furred  blood-coloured  papillae  with  the  burning 
sensation  (of  the  Pittam  in  them).  In  the  Kaphaja 
Kantaka  type  the  tongue  becomes  heavy,  thick  and 
grown  over  with  vegetation  of  slender  fleshy  warts  in  the 

14 


to6  THE   SOSHRUTA  SAMHitA.  CChap.  XVI. 

shape  o{  S'almali  thorns.  Alsbsa  :- The  severe  inflam- 
matory swelling  about  the  under  surface  of  the  tongue 
is  called  Alasa,  which  if  allowed  to  grow  on  unchecked 
gives  rise  to  numbness  and  immobility  of  the  organ 
and  tends  to  a  process  of  rapid  suppuration  at  its  base. 
The  disease  is  caused  by  the  deranged  blood  and 
Kapham.  The  Upa-jihva^ :  -  The  disease  in  which  a 
(cystic)  swelling  shaped  like  the  tip  of  the  tongue 
appears  about  the  under-surface  of  that  organ  by  raising 
it  a  little  is  called  Upa-jihvika  (Ranula).  The  accom- 
panying symptoms  are  salivation,  burning  and  itching 
sensations  in  the  affected  organ  ;  these  are  due  to  the 
deranged  Kapham  and  blood  (of  the  locality).      35 — 37. 

Disease  of  the  palate  :  — Diseases  which  are 
peculiar  to  the  part  of  the  palate  are  named  Gala-s'undika, 
Tundikeri,  Adhrusha,  Mansa-kachchapa,  Arvuda,  Mansa- 
sanghata,,  Talu-s'osha  and  Talu-pdka.     38. 

Gala-SUndika  :— The  diffused  and  elongated 
swelling,  caused  by  the  deranged  blood  and  Kapham, 
which  first  appears  about  the  root  of  the  palate  and 
goes  on  extending  till  it  looks  like  an  inflated  skin- 
bladder  is  called  Gala-s'undikd  (tonsilitis)  by  physicians. 
Thirst,  cough,  difificult  breathing  are  the  indications  of 
the  disease.  Tundikeri  : — A  thick  swelling  resembling 
the  fruit  of  the  Tundikeri  plant  in  shape  and  appearing 
about  the  root  of  the  palate  attended  with  a  burning, 
piercing  or  pricking  pain  and  suppuration  is  called 
Tundikeri  (abscess  of  the  tonsil).  Adhrusha  :— A  red, 
numbed  svvelling  appearing  about  the  same  region,  as 
the  effect  of  the  vitiated  blood  of  the  locality,  attended 
with  severe  fever  and  pain,  is  known  by  the  name  of 
Adhrusha.  Mjinsa-kachchapa:— A  brownish  and  slightly 
painful  swelling  somewhat  shaped  like  the  back  of  a 
tortoise  (and  appearing    about    the    region    of  the   soft 


Chap.  XVI.]  NIDANA   STHANAM.  lo; 

palate)  is  called  Mdnsa-kachchhapa.  The  disease  is, 
slow  in  its  growth  or  development  and  is  due  to  the 
deranged  Kapham.  Arvuda: — A  swelling  shaped  like 
the  petal  of  the  lotus  lily  and  appearing  in  the  region 
of  the  soft  palate  as  an  outcome  of  the  aggravated  con- 
dition of  the  local  blood  is  called  Arvudam.  The 
swelling  is  identical  with  the  Raktarvuda  described 
before.  Mausa-Saiighata :— A  vegetation  of  morbid 
flesh  at  the  edge  or  extremity  of  the  soft  palate 
through  the  action  of  the  derani^ed  Kapham  is  called 
Mansa-Sanghata.  It  is  painless.  Ta!u-piipputa: — A 
painless  permanent  swelling  to  the  shape  o(  the  Kola 
fruit  (plum)  caused  by  the  deranged  fat  and  Kapham 
at  the  region  of  the  soft  palate  is  called  Tdlu-pupputa. 
Tatiu-sosha  :— The  disease  of  the  soft  palate  in  which 
the  patient  feels  a  sort  of  parched  sensation  with 
dyspnoea  and  a  severe  piercing  pain  in  the  affected 
part  is  called  T^llu-sosha,  which  has  its  origin  in  the 
aggravated  condition  of  the  bodily  Vayu  acting  in 
concert  with  the  deranged  Pittam.  Ta^lu-patka  — The 
disease  in  which  the  deranged  Pittam  sets  up  a  very 
severe  suppurative  process  in  the  soft  palate  is  called 
Talu-paka,     39-47. 

The    diseases    of    the    throat    and 

larynx  :  —The  diseases  peculiar  to  the  throat  and  the 
larynx  are  seventeen  in  number  and  are  known  as 
the  five  types  of  Pohini,  Kantha-Saluka,  Adhijihva, 
Valaya,  Valasa,  Eka-vrinda,  Vrinda,  Sataghni,  Gilayu, 
Gala-vidradhi,  Galaugha,  Svaraghna,  Mansatana.  and 
Viddri.     48. 

General    features    of    Rohinis:-The 

aggravated  Vayu,  Pittam,  Kapham,  either  severally  or 
in  combination,  or  blood  may  affect  the  mucous  of 
the  throat  and  give  rise  to  vegetations  of   fleshy  papillae, 


lo8  THE  SUSHRUTA   SAMHITA.  [Chap.  XVI. 

which  gradually  obstruct  the  channel  of  the  throat 
and  bring  on  death.  The  disease  is  called  Rohini 
(Diphtheria^i.     49. 

The  V^taja  Rohini  :~A  vegetation  of  ex- 
tremely painful  fleshy  Ankuras  (nodules),  crops  up  all  over 
the  tongue  which  tend  to  obstruct  the  passage  of  the 
throat  and  are  usually  accompanied  by  other  distressing 
symptoms  characteristic  of  the  deranged  Vayu.  Pittaja- 
Eohini  :— The  Ankuras  (nodules)  in  the  present  type  are 
marked  by  speedy  growth  and  suppuration,  and  are 
accompanied  by  a  burning  sensation  and  high  fever. 
Kaphaja  Rohini :  —The  Ankuras  (nodules)  become 
heavy,  hard  and  characterised  by  slow  suppuration 
gradually  obstructing  the  passage  of  the  throat.     50-52. 

The    Sannipatika     Type  :— Suppuration 

takes  place  in  the  deeper  strata  of  the  membrane  ac- 
companied by  all  the  dangerous  symptoms  peculiar  to 
the  three  aforesaid  types  of  the  disease.  It  is  rarely 
amenable  to  treatment.  Rakfcaja  Type  : -Symptoms 
characteristic  of  the  Pittaja  type  of  the  disease  are 
present  and  the  fleshy  outgrowth  formed  in  the  throat, 
is  found  to  be  covered  with  small  vesicles.  This  type 
is  incurable.*     53~54 

Kantha-^alukam  :  -The  disease  in  which  a 
hard  rough  nodular  growth  (Granthi)  in  the  shape  of  a 
plum-stone  crops  up  in  the  throat,  which  seems  as  if  it 
has  been  stuffed  with  the  bristle  of  a  S'uka  insect  or 
been  pricked  by  thorns  is  called  Kantha-Salukam.  The 
disease  is  due  to  the  action  of  the  deranged  Kapham. 
It  is  amenable  to  surgical  treatment  only.  Adhijihva : — 
A  small  swelling  like  the  tip  of  the  tongue  caused  by  the 

*  The  reading  Sadhya  (curable)  which  is  to  be  met  with  in  the  several 
printed  editions  of  Madhab's  Nidanam  in  lieu  of  the  reading  Asadhya 
'incurable)  is  not  to  our  mind  correct, 


Chap.  XVI.]  NIDANA   STHANAM.  I09 

deranged  blood  and  Kapham  over  the  root  of  the  tongue 
is  called  Adhijihva,  which  should  be  given  up  as  soon  as 
suppuration  sets  in.  Valaya  :— A  circular  or  ring-shaped 
raised  swelling  obstructing  or  closing  up  the  upper  end  of 
the  oesophagus  (structure  of  oesophagus)  is  called  Valaya. 
It  cannot  be  cured  and  hence  should  be  given  up.  It  is 
due  to  the  deranged  action  of  the  Kapham  in  the 
locality.  Valatsa  :  —The  disease  in  which  the  unusually 
aggravated  Vayu  and  Kapham  give  rise  to  a  swelling 
in  the  throat,  which  is  extremely  painful  and  causes  a 
difficulty  of  respiration,  ultimately  producing  symptoms 
of  complete  asphyxia  is  called  Valasa  by  learned 
physicians  and  is  very  difficult  to  cure.     55 — 58. 

Eka-vrinda  and  Vrinda*:— The  disease  in 

which  a  circular,  raised,  heavy  and  slightly  soft  swelling 
appears  In  the  throat  attended  with  Itching,  a  slightly 
burning  sensation  and  a  slight  suppuration  is  called 
Eka-vrinda.  The  disease  is  due  to  the  effect  of  vitiated 
blood  and  Kapham.  The  disease  in  which  a  round 
elevated  swelling  attended  with  high  fever  and  a  slightly 
burning  sensation  is  formed  in  the  throat  through  the 
aggravated  condition  of  the  blood  and  Pittam  is  called 
Vrinda.  A  piercing  pain  in  the  swelling  points  to  its 
Vataja  origin.     59—60. 

^atagChni  : — The  disease  in  which,  through  the 
concerted  action  of  the  deranged  Vayu,  Pittam  and 
Kapham,  a  hard  throat  obstructing  Varti  fjagged  mem- 
brane; edged  like  a  Sataghni-f  and  densely  beset  with 
fleshy  excrescences  is  formed  along  the    inner   lining   of 

*  The  diseases  of  the  throat  are  17  in  number.  Taking  Vrinda  as  a 
separate  disease  they  amount  to  18  ;  but  Vrinda,  affecting  similar  place 
and  being  similar  in  appearance  with  but  a  slight  distinction  of  symptoms, 
is  only  a  particular  state  of  Eka-vrinda,  and  not  a  separate  disease. 

t  Sataghni  is  a  kind  of  weapon  uged  in  ancient  warf?ire, 


iro  THE  SUSHRUTA  SAMHITA  [Chap.   XVI. 

that  pipe  is  denominated  as  Sataghni.  Various  kinds 
of  pains,  (characteristics  of  each  of  the  deranged  Vayu, 
Pittam  and  Kapham)  are  present  in  this  type  which 
should  be  necessarily  considered  as  irremediable.     6i. 

GilStyu  : — The  disease  in  which  the  aggravated 
Kapham  and  blood  give  rise  to  a  hard  and  slightly 
painful  (D.  R  extremely  painfull  glandular  swelling 
in  the  thrviat  to  the  siz^  of  the  stone  of  the  Amalaka 
fruit  is  called  Gilayu.  A  sensation  as  if  a  morsel  or 
bolus  of  food  is  stuck  in  the  throat  is  experienced  which 
by  its  very  nature  is  a  surgical  case.     62. 

Gala-vidradhi:  — Thediseascin  whichan exten- 
sive swelling  occurs  along  the  whole  inner  lining  of  the 
throat,  owing  to  the  concerted  action  of  the  deranged 
Vayu,  Pittam  and  Kapham  is  called  Gala-vidradhi  which 
exhibits  all  the  features  present  in  a  Vidradhi  of  the 
Sanipatika  type.  Galaugha  : — The  disease  in  which  a 
large  swelling  occurs  in  the  throat  so  as  to  completely 
obstruct  the  passage  of  any  solid  or  liquid  food  and  also 
that  of  Udana-vayu  (choking  the  pharynx,  larynx  and 
the  mouth  of  the  esophagus),  attended  with  a  high  fever 
is  called  Galaugha,  the  origin  of  which  should  be  as- 
cribed to  the  action  of  the  deranged  blood  and  Kapham. 
Svaraghna:  -The  disease  in  which  the  patient  faints 
owing  to  the  choking  of  the  larynx  by  the  deranged 
Kapham  which  is  marked  by  stertorous  breathing,  hoarse- 
ness, dryness  and  paralysed  condition  of  the  throat  is 
called  Svaraghna  which  has  its  origin  in  the  deranged 
Vayu.     63—65. 

IVIanSatana  : — The  disease  in  which  a  pendent, 
spreading  and  extremely  painful  swelling  appears  in 
the  throat  which  gradually  obstructs  the  pipe  is  called 
Mansatana.  It  invariably  proves  fatal  and  is  caused 
by  the  deranged  Vdyu,  Pittam  ^nd  Kapham      6() 


Chap.  XVI.]  NIDANA   STHANAM.  til 

Vidari  :  -The  disease  In  which  a  copper-coloured 
swelling  occurs  in  the  throat,  marked  by  a  pricking  and 
burning  sensation,  and  the  flesh  of  the  throat  gets 
putrefied  and  sloughs  off  (and  emits  a  fetid  smell)  is 
called  Vidari.  The  disease  is  of  a  Pittaja  origin  and  is 
found  to  attack  that  side  of  the  throat  on  which  the 
patient  is  in  the  habit  of  lying.     6^. 

The  disease  in  the  entire  cavity:  — 

Cases  which  are  found  to  invade  the  entire  cavity  of 
the  mouth  (without  being  restricted  to  any  particular 
part  thereof)  may  be  either  due  to  Vataja,  Pittaja, 
Kaphaja  or  Raktaja  type  and  are  known  by  the  general 
name — Savra-Sara.     (i"^. 

In  the  Vataja  type  the  entire  cavity  of  the  mouth 
is  studded  with  vesicles  attended  with  a  pricking 
sensation  in  their  inside.  In  the  Pittaja  type  a  large 
number  of  small  yellow  or  red-coloured  vesicles  attended 
with  a  burning  sensation  crops  up  on  the  entire  (mucous 
membrane  lining  the  cavity  of  the  mouth.  In  the  Kaphaja 
variety  a  similar  crop  of  slightly  painful,  itching  vesicles 
of  the  same  colour  as  the  skin  (is  found  on  the  entire 
inner  surface  of  the  mouth.)  The  blood-origined  Kaktaja 
type  is  nothing  but  a  modification  of  the  Pittaja  one 
(giving  rise  to  similar  symptoms) ;  it  is  also  by  others 
called  Mukha-patka.    69-72. 

Thus  ends  the  sixteenth  Chapter  of  the  Nidana  Sthanam  in  the  Sus'ruta 
Samhita  which  treats  of  the  Nidanam  of  the  diseases  of  the  mouth. 


Here  ends  the  Nidana  Sthanam. 


THE 

SUSRUTA  S AMHIT A 

SARIRA  STHANAM. 

(Section  on  Anatomy). 
-.o: 

CHAPTEE  L 

Now  we  shall  discourse  on  the  Sdriram  which  treats 
of  the  science  of  Being  in   general     (Sarva-Bhuta 

Chintsi  ^gfriram).     i. 

The  latent  (lit :  unmanifest)  supreme  nature  (Prakriti) 
is  the  progenitor  of  all  created  things.  She  is  self- 
begotten  and  connotes  the  three  fundamental  or  primary 
virtues  of  Sattva,  Rajas  and  Tamas.  She  is  imaged  or 
embodied  in  the  eightfold  categories  of  Avyakta  (un- 
manifest), Mahdn  (intellection),  Ahamkdra  (Egoism)  and 
the  five  Tanmdtras  or  elementals  (proper  sensibles)  and 
is  the  sole  and  primary  factor  in  working  out  the  evo- 
lution of  the  universe.  The  one  absolute  and  original 
nature  is  the  fundamental  stone  house  of  materials  out 
of  which  the  bodies  of  all  self-conscious  (Karma-Purusha) 
working  agents  (agents  who  come  into  being  through  the 
dynamical  energy  of  their  acts  or  Karmas)  have  been 
evolved  in  the  same  manner  as  all  water,  whether  con- 
fined in  a  tank  or  a  reservoir,  or  coursing  free  through 
the  channels  of  streams  and  of  mighty  rivers,  have  been 
welled  up  from  the  one  and  shoreless  primordial  ocean.    2. 

Out  of  that  latent  unmanifest  (Avyakta)  or  original 
nature  (impregnated  by  the  atoms  or  elemental    units   of 

15 


ri4  THE  SUSHRUTA   SAMHITA.  [Chap.  I. 

consciousness  or  Purushas)  Intellection  or  Mahdn  has 
been  evolved,  and  out  of  Mahdn  egoism.  This  Mahan  or 
intellection  should  be  likewise  considered  as  partaking 
of  the  three  fundamental  attributes  (Sattva,  Rajas,  and 
Tamas)  of  the  latent  (Avyakta)  or  original  nature.* 
Ahamkara  or  egoism  in  its  turn  may  be  grouped  under 
three  subheads  as  the  Vaikdrika  Taijasa  (operative)  or 
Rdjasika,  and  Bhutadi  (illusive  or  Tamasika).     3. 

The  eleven  organs  of  cognition,  communication  or 
sense  perception  have  emanated  from  the  co-operation 
of  the  aforesaid  Vaikarika  Ahamkara  with  the  Taijasa 
or  Rajasa.  They  are  the  ears,  skin,  eyes,  tongue,  nose, 
speech,  hands,  genitals,  anus,  feet  and  the  mind  (Manah). 
Of  these  foregoing  organs  the  first  five  are  intellectual 
or  sense  organs  (Vuddhi-Indriya) ;  the  next  five  being 
operative  (Karma-Indriya\  The  mind  (Manah)  par- 
takes of  the  character  of  both  the  intellectual  and 
operative  organs  alike.     4-5. 

The  five  Tanmatras  or  elementals  (or  the  five  proper 
sensibles  of  hearing,  touch,  sight,  taste,  and  smell)  charac- 
terised by  the  Nescience,  etc.  have  been  evolved  out  of  the 
Bhutddi  etc.  (or  Tamasa  Ahamkara)  concerted  with  the 
Taijasa  Ahamkdra  through  the  instrumentality  of  the 
Vaikarikam.  The  gross  or  perceptible  modifications  of 
these  five  Tanmatras  are  sound,  touch,  taste,  sight  and 
smell.  From  the  combination  of  the  aforesaid  five 
Tanmdtras  (Bhutadi)  taken  one  at  a  time,  have  succes- 
sively emanated  the  five  gross  matters  of  space   such   as 

*  Sattva,  Rajas  and  Tamas  :— Adhesion,  cohesion  and  disintegration 
in  the  Physical  plane  ;  affection,  love  and  hate  in  the  moral ;  emancipa. 
tion,  spiritual  affinity  and  sin  in  the  Psychic. 

Simply  phenomenal  or  the  simple  outcome  of  the  phenomenal  evolution 
without  being  by  othet  specific  attributes  of  matter  and  hence  Skttvika  or 
iUuminatiDg  or  quasi-spiritual. 


Chap,  i.]  SARIRA  STHaNAM.  11$ 

ether,  air,  heat,  (fire,)  fluid  (water),  and  earth  (solid). 
These  twenty  four  categories  combinedly  form  what  is 
technically  known  as  the  twenty  four  elements 
(Tattvas).  Thus  we  have  discoursed  on  the  twenty  four 
fundamental  principles  (Chaturvins'ati-tattvam).     6. 

Hearing,  touch,  sight,  taste  and  smell  respectively 
form  the  subjects  of  the  five  intellectual  (Vuddhi) 
organs  of  man,  whereas  the  faculty  of  speech,  handling, 
pleasure,  ejections  or  evacutation,  locomotion  successively 
belong  to  the  (remaining)  five  operative  (Karma-Indriya) 
ones.  The  original  nature  (Avyakta),  Mahan*  (intellec- 
tion), Egoism  (Aliamkara),the  five  sensibles  (Tanmatras), 
and  the  five  gross  material  principles  in  their  nascent 
stage  in  evolution  form  what  is  included  within  the  eight 
categories  of  Nature  (Prakriti),  the  remaining  sixteen 
categories  being  her  modifications  (Vikara),  The  objects 
of  intellection  (Mahan)  and  Egoism  (Ahamkdrd)  as  well 
as  of  the  sense  organs  of  knowledge  and  actions  are  the 
material  principles  (Adibhautika)  though  they  are  spiri- 
tual in  themselves  and  in  their  nature. 

The  tutelary  god  of  intellection  (Buddhi)  is  Brahma. 
The  god  Is'vara  is  the  presiding  deity  of  the  sense  of 
egoism  (Ahamkdra)  ;  the  moon  god  is  that  of  the  mind 
(Manah) ;  the  quarters  of  the  heaven,  of  the  ears ;  the 
wind  god  is  that  of  the  skin  ;  the  sun  is  that  of  the 
eyes ;  the  water  is  that  of  the  taste  ;  the  earth  is  that  of 
the  smell  ;  the  fire  is  that  of  the  speech  ;  Indra  is  that  of 
the  hands  ;  Vishnu  is  that  of  the  legs  ;  Mitra  is  that  of 
the  anus  and  Prajapati  is  that  of  the  organs  of 
generations.     7. 

*  Mahan,  Ahamkara  and  the  five  Tanmatras,  though  but  modifications 
of  the  original  Nature  in  themselves,  have  been  included  within  the 
category  of  Nature  (Prakriti)  in  asmuch  as  they  form  the  immediately  prior 
or  antecedent  conditions  of  the  evolution  of  the  phenomenal  universe. 


ri6  THE  SUSHRUTA  SAMHITA.  [Chap.  t. 

All  the  aforesaid  (twenty-four)  categories  or 
elementals  (Chaturvinsati-Tanmdtras)  are  devoid  of 
consciousness.  Similarly  the  modifications  of  the 
primal  cause  of  Prakriti  such  as  the  Mahat  etc.  are 
all  bereft  of  consciousness  in  as  much  as  the  cause 
itself,  the  Avyakta  or  the  original  nature  is  devoid  of 
it.  The  Purusha  or  the  self-conscious  subjectivity, 
enters  into  the  primal  cause  (Mula-Prakriti  or  original 
Nature)  and  its  necessary  effect  (the  evolved  out 
phenomena)  and  makes  them  endued  with  his  own 
essence  or  self-consciousness.  The  preceptors  and  holy 
sages  explain  the  proposition  by  an  analogy  that  as 
the  milk  in  the  breast  of  a  mother,  though  unconscious 
in  itself,  originates  and  flows  out  for  the  growth  and 
sustenance  of  her  child  ;  (as  the  semen  in  the  organism 
of  an  adult  male  though  devoid  of  consciousness,  flows 
out  during  an  act  of  sexual  intercourse)  ;  so  these 
twenty-four  primary  material  principles  (elementals), 
though  unconscious  in  themselves,  tend  to  contribute 
towards  the  making  of  the  self-conscious  self  or  the 
universal  individual  (the  aggregate  of  limited  or  condi- 
tional selves)  for  the  purpose  of  working  out  his  final 
liberation  or  emancipation  i.e.,  attainment  of  the  stage  of 
pure  consciousness  or  perfect  knowledge.     8. 

Now  we  shall  describe  the  tracts  which  the  Purusha 
(subjective  or  self-conscious  reality)  and  Prakriti  or 
nature  (passive  non-conscious  eternity)  pass  in  com- 
mon as  well  as  those  wherein  they  differ  from  each 
other.     9. 

Traits  of  commonalty  :—Both  the  Purusha 
and  Prakriti  are  eternal  realities,  both  of  them  are  un- 
manifest,  disembodied,  without  a  beginning  or  origin, 
eternal,  without  a  second,  all — pervading  and  omni* 
present. 


Chap.  I.]  SARIRA  StHANAM.  II? 

Traits  of   diversity  :— Of  the    Purusha    and 

the  Prakriti,  only  the  latter  is  non-conscious  and 
possesses  the  three  fundamental  qualities  of  Sattva, 
Rajas  and  Tamas.  Prakriti  performs  the  function 
of  the  seed  or  in  otherwords  she  lies  inherent  as  the 
seed  or  the  primary  cause  in  the  latter  phenomenal 
evolution  of  the  Mahat  etc.  and  contributes  the  maternal 
element  in  the  conception,  development  and  birth  of 
the  primordial  cosmic  matter  (phenomenal  universc\ 
fecundated  by  the  Purusha  (self-conscious  subjectivity) 
in  its  different  stages  of  evolution.  These  stages  are 
called  Mahat,  Ahamkara  etc. ;  and  Prakriti  is  not  indif- 
ferent, as  the  Purusha  is  to  the  pleasures  and  misery  of 
life.  But  the  Purusha  (units  or  atoms  of  consciousness), 
devoid  of  the  threefold  virtues  of  Sattva  etc.  are  non- 
concerning  hence  non-producing  and  bereft  of  the  seed- 
attributes  of  lying  inherent  in  all  as  the  primary 
cause  of  evolution.  They  are  mere  witnesses  to  the 
joys  and  miseries  of  life,  and  do  not  participate  in  their 
enjoyment  though  imprisoned  in  the  human  or- 
ganism.    10 

Since  an  effect  is  uniform  in  virtue  to  its  producing 
cause,  the  evolution ised  effects  or  products  of  the  Pra- 
kriti such  as  the  Mahat,  Ahamkara  etc.  must  needs  par- 
take of  the  three  fundamental  qualities  (Sattva,  Rajas 
and  Tamas)  which  are  predicated  of  the  Prakriti.  In 
other  words,  these  Mahat,  Ahamkara,  etc,  are  but  the 
modifications  of  the  three  fundamental  qualities  of 
Sattva,  Rajas  and  Tamas.  Moreover,  certain  authorities 
hold  that  the  Purushas  are  units  of  self-consciousness, 
possessed  of  the  three  aforesaid  qualities  owing  to  their 
antecedent  conditions  or  causes  (the  gross  material 
universe)  being  permeated  with  and  characterised  by 
them.     II. 


Il8  THE  SasHRUTA  SAMHITA.  [Chap.  1. 

IVIetrical  Text  (Vaidyake.)  :— It  is  asserted  in 
the  Ayurveda  that  it  is  only  the  gross-sighted  ones 
and  men  capable  of  observing  only  the  superficial 
appearances,  who  confound  eternal  order  or  se- 
quence of  things  and  events  (Svabhd,ba),  God  ( Is  vara)  * 
Time  (Kala),  sudden  and  unlooked  for  appearances 
of  the  phenomena  (Yadrichchha),  Necessity  (Niyati)  and 
transformation  (Parinama)  with  the  original  Nature 
(Prakriti).  The  five  different  forms  of  matter  (such  as 
Ether  etc  )  are  nothing  but  the  modifications  or  trans- 
formed states  of  the  original  nature  and  are  characterised 
by  the  three  universal  qualities  of  Sattva,  Rajas  and 
Tamas,  and  all  created  things,  whether  mobile  or  im- 
mobile, should  be  considered  as  alike  exponented  by  the 
same.  In  the  Science  of  medicine  the  cause  of  a 
disease  is  the  one  sole  aim  to  be  achieved  by  means  of 
administering  proper  medicinal  remedies  (matter),  and 
hence  the  properties  of  matter  are  the  only  fit  subject 
to  be  dealt  with  in  a  book  on  pharmacy.  And  further, 
because  the  immediately  prior  cause  of  the  human 
organism  is  a  proper  and  congenial  admixture  of  the 
sperm  and  ovum  (matter),  the  sense  organs  are  the 
resultants  of  phenomenal — evolution  of  matter,  and  the 
objects  of  sense  perception  are  equally  material  or 
phenomenal  in  their  nature.     12-14, 

IVlemorable  verse  :  -A  man  by  a  particular 
organ  of  his  body  perceives  the  same  matter  which 
forms  the  proper  object  of  that  sense  organ  in  as  much 
as  the  perceiving  sense  organ  and  the  perceived  sensible 
are  produced  by  the  same  material    cause.     The  matter, 

*  The  second  factor  according  to  Sankhya,  in  the  order  of  cosmic 
evolution,  which  as  the  seed  of  the  universe,  was  hid  in  the  burning  disc 
of  the  central,  primordial  Sun,  out  of  which  the  different  solar  systems 
have  come  into  being. 


Chap.  I.]  SARIRA  STHANAM.  II9 

which  specifically  forms  the  object  of  a  particular  sense 
organ,  cannot  be  perceived  by  the  other.  We  see  a 
flower  with  the  eyes  and  not  with  the  nose.     15. 

The  Science  of  medicine  does  not  lay  down  that  the 
self-conscious  Selves  (Kshetrajna)  are  all  pervading,  but 
on  the  contrary  it  asserts  that  they  are  real  and  eternal 
and  are  born  in  the  planes  of  divine,  human  or  animal 
existence  according  to  their  good  or  evil  deeds  in  life. 
The  existence  of  these  self-conscious  entities  can  be 
ascertained  duly  by  inference  inasmuch  as  they  are 
extremely  subtle  in  their  essence.  The  self-conscious 
self  is  possessed  of  infinite  consciousness,  is  real  and 
eternally  subject  to  the  process  of  being  evolved  out 
into  a  finite,  organic  individual  through  the  dynamics 
of  the  combined  sperm  and  ovum.  The  view  is  further 
corroborated  by  a  dictum  of  the  Sruti  which  holds  that 
Purusha  (individual)  is  nothing  but  a  combination  of 
a  self-conscious  self  and  the  five  kinds  of  matter  (Maha- 
bhutas)  formed  into  an  organic  body.  This  Purusha  or 
individual,  which  is  called  Individual  of  action  (Karma- 
Purusha),  falls  within  the  scope  of  the  science  and  art 
of  medicine.*     16 — 17. 

*  Here  lies  the  difference  between  Sankhya  and  Ayurveda.  While  the 
former  discourses  on  in  material  character  of  the  soul,  the  latter  com- 
mences to  discuss  on  the  questions  how  the  material  environment  in 
which  the  soul  is  said  to  inhabit  is  evolved,  and  how  the  inclusion  of 
the  spiiilual  within  the  material  organism  is  effected. 

Hence  Sus'ruta's  Physiology,  like  that  of  Charaka,  is  in  the  strictest 
sense  of  the  word  molecular  and  his  science  of  life  is  an  attempt  at 
explanation  of  consciousness  from  the  materialistic  standpoint,  which 
agrees  with  the  views  of  modern  western  science.  Intellect  according  to 
Sus'ruta  is  material  and  belongs  to  the  same  category  which  the  Sankhya 
system  of  philosophy  in  its  explanation  of  evolution  enumerates  originally 
as  seven.  The  soul,  accordtng  to  Sus'ruta,  is  an  independent  existence  and 
is  often  associated  with  what  is  called  life.  Where  there  is  life,  there  is  a 
soul,  and  it  is  not  everywhere  the  same.    The  soul  in  Sus'cula  is  individual 


120  THE  SUSHRUTA  SAMHITA.  [Chap.  I. 

The  attributes  of  an  organic  indi- 
vidual : — Longing  for  pleasure,  shunning  of  pain, 
enemity,  energetic  undertaking  of  work,  respiration 
(Prdna\  emission  of  flatus  (Apana),  closing  and  opening 
of  the  eyelids,  intellect  (Vuddhi),  sentiment  (Manah), 
deliberation,  discretion,  memory,  knowledge  of  art, 
perseverance,  sensation  and  perception,  are  the  attributes 
of  an  organic  individual.     i8. 

Distinctive  features  of  the  different 
classes  of  mental  temperaments  :— An 

absence  of  all  killing  or  hostile  propensities,  a  judicious 
regimen  of  diet,  forbearance,  truthfulness,  piety,  a  belief 
in  God,  spiritual  knowledge,  intellect,  a  good  retentive 
memory,  comprehension,  and  the  doing  of  good  deeds 
irrespective  of  consequences,  are  the  qualities  which 
grace  the  mind  of  a  person  of  a  Sa'ttvika  temperament. 
Feeling  of  much  pain  and  misery,  a  roving  spirit,  non- 
comprehension,  vanity,  untruthfulness,  nonclemency, 
pride,  an  over  winning  confidence  in  one's  own  excel- 
lence, lust,  anger  and  hilarity  are  the  attributes  which 
mark  a  mind  of  the  Raijashika  cast.  Despondency, 
stupidity,  disbelief  in  the  existence  of  God,  impiety, 
stupification  and  perversity  of  intellect,  lethargy  in 
action  and  sleepiness  are  the  qualities  which  mark  a 
mind  of  a  Taimasliika  stamp.     19, 

The  distinctive  traits  of  the  five 
material  of  Elements  of  the  world  ;— 

The  properties  of  Akas'a  (ether)  are  sound,  the  sense  of 
hearing,  porosity  and  differentia  evolution  of  the  veins, 
ligaments  etc.  into  their  characterised  species  (Viviktatd.) 

Xif^^  ^^^'.  ^"^  takes  cognisance  of  sorrow,  disease  and  death  by  its 
union  with  the  body  (  ^t  ?T^UJ^  sjfjf^C  ^^^\m  g»iq  9gj^^  )•  Hence 
the  living  frame  together  with  the  soul  that  ia  said  to  inhabit  it  forms  the 
subject-matter  of  Ayurvedic  medical  treatment,     Ed. 


Chap.  I J  SARIRA   STHANAM.  121 

The  properties  Vatya  (etherin)  are  touch,  the  skin,  all 
functional  activities  of  the  organism,  throbbing  of  the 
whole  body  (Spandana)  and  lightness.  The  properties 
of  Tejl  (fire  or  heat)  are  form,  the  eyes,  colours,  heat, 
illumination,  digestion,  anger,  generation  of  instanta- 
neous energy  and  valour.  The  properties  of  Apa  (water 
or  liquid)  arc  taste,  the  tongue,  fluidity,  heaviness,  cold- 
ness, olioginousncss  and  semen.  The  properties  or 
modifications  of  Prithivi  (the  earth  matter  or  solid) 
are  smell,  the  nose,  embodiment  and  heaviness.     20. 

Of  these  the  ether  or  Akasa  abounds  in  attributes  of 
the  Sdttvika  stamp,  the  Vayu  or  etherin  in  Rdjashika, 
the  Teja  in  Sattvika  and  Rajashika,  the  water  in  S^ttvika 
and  Tamashika  and  the  earth  in  Tamasha  attributes.  21. 

There  are   IVIemorable  Verses  :— These 

qualities  are  found  to  characterise  and  enter  intothe*suc- 
cessive  elements  in  the  order  of  their  enumeration.  The 
specific  attributes  of  these  elements  are  manifest  in  the 
substances  which  are  respectively  originated  from  them. 
The  term  Prakriti  or  original  nature  connotes  the  eight 
categories  (of  Avyakta,  Mahan,  Ahamkara,  and  the  five 
Tanmatras)  and  the  rest  of  the  twenty  four  fundamental 
principles  are  its  modifications.  The  Furusha  forms  the 
twentyfifth principle.  These  twentyfive  fundamental  prin^ 
ciples  of  cosmogony  have  been  dealt  w^ith  in  the  present 
treatise  ^Salya-Tantram)  as  well  as  in  the  other  treatise 
(Salaky-Tantram  and  Sankhya  Philosophy).     22 — ■23. 

Thus  ends  the  first  Chapter  of  the  S'arira  Sihananin  the  Sus'ruta  Samhita 
which  deals  with  the  science  of  Being  in  general. 


16 


CHAPTER  II. 

Now  we  shall  discourse  on  the  Sariiam  whicii 
treats    of    the   purification    of    semen    and     cataminal 

fluid    etc.      (Sukra-^onita-^uddhirnama 
^ariram).    i. 

A  man  is  incapable  ol  begetting  children,  whose 
seminal  fluid,  affected  by  the  aggravated  Vayu,  Pittam  or 
Kapham,  emits  a  cadaverous  smell,  or  has  acquired 
a  clotted  or  shreddy  character  or  which  looks  like 
putrid  pus,  or  has  become  thin,  or  smells  like  urine 
or   stool,     2. 

Deranged  Semen  :  — Semen  vitiated  by  the 
deranged  Vayu  acquires  a  (reddish-black)  colour  and 
gives  rise  to  a  pain  (piercing  and  cutting  etc.)  which 
characterises  the  Vayu  (at  the  time  of  being  emitted). 
Similarly  semen  deranged  by  the  Pittam  gets  a  (yellowish 
or  bluish  etc.)  colour  and  produces  the  specific  pain 
(burning  and  sucking  etc.)  of  the  deranged  Pittam 
(at  the  time  of  emission).  Semen  vitiated  by  the  action 
of  the  deranged  Kapham  has  a  (white)  colour  and  pro- 
duces the  pain  (itching  sensation  etc.)  peculiar  to  the 
deranged  Kapham  (at  the  time  of  its  outflow).  The 
semen  vitiated  by  blood  is  tinged  with  a  bloody  hue, 
produces  all  kinds  of  pain  peculiar  to  the  deranged 
Sonita  (Pittam).  The  semen  smells  like  a  putrid  corpse 
and  is  emitted  in  large  quantities.  The  shreddy  or 
clotted  character  of  the  fluid  (Granthila)  should  be 
ascribed  to  the  action  of  the  deranged  Vayu  and 
Kapham.  If  vitiated  by  the  action  of  the  deranged 
Pittam  and  Kapham  it  looks  like  putrid  pus  (Puti- 
puya).    Thin  semen  is  caused  by  the  deranged  Vayu  and 


Chap,   II.]  SARIRA   STHANAM.  '  1 23 

Pittam  as  described  before.  A  concerted  action  of  the 
deranged  Vayu,  Pittam,  and  Kapham  causes  the  semen 
to  smell  like  urine  or  fecal  matter.  Of  these,  the 
cadaverously  smelling,  shreddy  and  clotted,  putrid  pus- 
like and  thinned  semen  can  be  remedied  and  corrected 
only  with  the  greatest  difficulty  ;  while  the  one,  having 
the  smell  of  stool  or  urine,  should  be  regarded  as  beyond 
cure.     The  remaining  kinds  arc  curable.     3. 

Deranged  Artavam  :— The  catamenial  fluid 
(Artavam)  of  a  woman  vitiated  by  the  deranged  Vayu, 
Pittam,  Kapham,  or  blood,  either  severally  or  in 
combination  of  two  or  more  Doshas  should  be  likewise 
considered  as  unfit  for  the  purpose  of  fecundation. 
Vitiated  catamenial  fluid  exhibits  the  characteristic 
colour  and  pain  of  the  deranged  Doshas  or  blood 
(underlying  at  its  roots).  Of  the  several  kinds  (of 
vitiated  catamenial  fluids)  those  which  smell  like  a  putrid 
corpse  or  fetid  pus,  or  which  is  clotted,  or  is  thin,  or  emits 
the  smell  of  urine  or  fecal  matter,  should  be  deemed  as 
being  beyond  remedy,  the  rest  being  amenable.     4. 

IVIemorable  Verses  :— The  first  three  types 

of  seminal  derangements  or  defects  should  be  corrected 
by  an  intelligent  physican  with  an  application  of 
medicated  oil  etc.  ^Sneha-karma),  diaphoric  measures 
etc*  or  uretheral  injections  ^Uttara-vasti).  A  medi- 
cated Ghrita  prepared  with  a  (decoction  and  Kalka 
of;  Dhdtaki  flowers,  Khadira^  Dddima  and  Arjuna 
barks  should  be  given  to  drink  to  a  man  whose 
semen  em'ts  a  cadaverous  smell  (Kunapa\  As  an  alter- 
native, a  medicated  Ghrita  prepared  with  (a  decoction 
and  levigated  paste  or  Kalka  of)  the  drugs  forming  the 
S^dlasdrddi  group  should  be  given  to  him.     In  a  case  of 

*    The  word  "  Adi  "  in  the  text  inclutles  emelic>,    purgatives,    Anuva- 
sanam  and  Aslhapanam  meai^ures  according  to  their  specific  Doshas. 


124  THE  SUSIIRUTA  SAMIIITA.  [Chap   II. 

clotted  and  shreddy  semen  (Granthi),  the  patient  should 
be  made  to  drink  a  medicated  Ghrita  prepared  with  a 
(decoction  and  Kalka  of)  S'athi,  or  with  an  alcaline  solu- 
tion prepared  from  the  ashes  of  the  burnt  P  aids' ha  wood. 
In  the  case  of  a  pus-like  appearance  of  the  fluid  the 
patient  should  be  treated  with  the  medicated  Ghrita 
prepared  with  (a  decoction  and  Kalka  of)  the  drugs 
included  within  the  groups  of  Parushakddi  and  Vatddi 
(Nyagrodhadi)  Ganas,  In  a  case  of  thin  semen, 
measures  laid  down  under  the  same  head  before,  as  w^ell 
as  those  to  be  hereafter  described  should  be  resorted  to. 
Similarly  a  medicated  Ghrita,  prepared  with  (a  de- 
coction and  Kalka  of)  Chiti^akk  roots ^  Ushira  roots  and 
Hingu,  should  be  drunk  in  a  case  of  the  semen  smelling 
like  urine  or  fecal  matter.  In  all  cases  of  seminal 
disorders  as  well  as  in  menstrual  anomalies,  Uttara- 
Vssti  (uretheral  or  vaginal  injection)  should  be  made 
after  having  recourse  to  the  application  of  medicated 
oil  etc.  (Sneha-karma\  purgatives,  emetics,  Asthapana 
and  Anuvasana  measures.      5 — 12 

Treatment   of  derang^ed  Artava:— In 

all  the  four  cases  when  the  catamenial  blood  would  be 
found  to  be  vitiated  (by  the  deranged  Vayu,  Pittam, 
Kaphah  or  Sonita),  the  preliminary  remedial  measures  of 
the  application  of  oil  etc.  purgatives  etc.  (Pancha-karma) 
should  be  first  employed  and  then  the  following 
measures  should  be  undertaken  viz.  application  of 
Kalka,  (levigated  paste  of  drugs),  Pichu  (medicated 
plugs— pecharies  etc.),  Pathya  (diet)  and  Achamaua 
^vashes  with  decoctions)  as  described  under  the  treat- 
ment of  Gyonoecological  cases  etc.  Appearance  of 
clots  of  blood  (Granthi)  in  place  of  the  healthy  men- 
strual fluid  would  indicate,  decoction  or  a  pulverised 
compound  of  P^th^,  Trushuna  and  Vrikshaka    (Kutaja). 


Chap.  II.]  NIDANA   STIIANAM.  125 

A  decoction  o^  B/iadras^'rifam'^  and  Chandanam  is  indica- 
ted in  the  case  when  the  menstrual  fluid  would  smell  like 
fetid  pus,  or  contain  marrow.  The  remedies  described 
under  the  head  of  seminal  disorders,  should  be  likewise 
prescribed  in  cases  of  menstrual  anomalies  caused  by 
the  action  of  the  deranged  Vdyu,  Pittam  and  Kaphah 
according  to  the  requirements  of  each  individual  case 
under  treatment.  Sdli-rice,  barley,  wine  and  meat 
with  cholagogue  properties  should  be  deemed  as  a 
wholesome  diet  in  these  cases.     13 — 16. 

Traits  of  pure  and  healthy  semen 
and    menstrual    blood  :  — Semen    which    is 

transparent  like  crystal,  fluid,  glossy,  sweet  and  emits 
the  smell  of  honey  ;  or  like  oil  or  honey  in  appearance 
according  to  others,  should  be  considered  as  healthy. 
The  catamenial  blood  (Artava)  which  is  red  like  the 
blood  of  a  hare,  or  the  washings  of  shellac  and  leaves 
no  stains  on  cloths  (which  may  be  washed  off  by 
simply  soaking  them  in  water)  should  be  considered  as 
healthy.     17—18. 

Asrig'dara  (Menorrhagia)  :—  An  abnormal  or 
excessive  discharge  of  the  menstrual  blood  (Artava), 
or  its  long  persistence  even  after  the  wonted  time, 
or  its  appearance  at  a  premature  or  unnatural  period 
(as  well  as  contrarity  in  its  colour  or  properties)  is 
called  Asrigdara.  All  types  of  the  disease  (Asrigdara) 
are  attended  with  an  aching  in  the  limbs  and  a  painful 
flow  (of  the  catamenial  fluid).  In  case  of  excessive 
hoemorrhage  (from  the  uterus),  symptoms  such  as  weak- 
ness, vertigo,  loss  of  consciousness,  darkness  of  vision, 
or  difficult  breathing,  thirst,  burning  (sensation  of  the 
body),  delirium,   palour,   somnolence    and    other  Vataja 

*    Bhadras'riyam    is  8'richandanam    according    to    Dallana    or    white 
Sandal  \vood  according  Gayadasj^. 


126  THE  SUSHRUTA  SAMHITA.  [Chap.   II. 

troubles  (convulsion,  hysteria  etc.)  may  set  in.  A 
physician  should  treat  a  case  of  Asrigdara  with 
measures  and  remedies  as  laid  down  under  the  head  of 
R^kta-pittam  (hoemorrhage)  in  a  case  when  the 
patient  is  young  (of  sixteen  years),  careful  in  her  diet, 
and  the  disease  unattended  with  severe  complica- 
tions.     19 -2t. 

Amcnorrhoe  :  -In  a  case  of  suppression  of 
menstruation  (Amenorrhoe)  caused  by  the  obstruction 
of  the  deranged  Doshas  (Vayu  and  Kapham)  in  the 
passage,  the  patient  should  be  advised  to  take  fish, 
Kulattha  pulse,  Masha  pulse,  Kanjikam  fermented  sour 
gru  1  etc.),  Tila,  wine  (Sura),  cow's  urine,  whey,  half 
diluted  Takra,  curd  and  S^uktam  for  her  diet.  The 
symptoms  and  treatment  of  thin  and  scanty  menstrua- 
tion have  been  described  before.  Still  in  such  a  case 
measures  laid  down  for  the  treatment  of  Nashta-Rakta 
(amenorrhoe)  may  be  adopted.  Under  a  course  of 
treatment  described  as  before,  the  semen  or  the  cata- 
menial  blood  of  a  person  would  be  resorted  to  their 
healthy  and  normal  condition.     22 — 23. 

A  woman  with  (healthy)  catamenial  flow  should 
forego  the  bed  of  her  husband  during  the  first  three 
days  of  her  uncleanness,  as  well  as  day  sleep  and 
colly rium.  S'le  shall  not  shed  tears  nor  bathe,  nor 
smear  her  person  (with  sandal  paste  etc.\  nor  anoint 
her  body,  nor  pare  her  nail,  nor  run,  nor  indulge  in 
loud  and  excessive  laughter  and  talk,  nor  should  she 
hear  loud  noise,  nor  comb  her  hiir,  nor  expose  herself 
to  droughts,  nor  do  any  fatiguing  work  at  all  ;  because 
if  a  woman  sleeps  in  the  day  time  (during  the  first  three 
days  of  her  period)  her  child  of  subsequent  conception 
becomes  sleepy  or  somnolent.  The  woman  who  applies 
collyrium  along  her  eyelids    (during   those   days),   giv^es 


Cliap.  il.]  SARIRA  STHANAM.  1 27 

birth  to  a  blind  child  ;  by  shedding  tears  (during  her 
period)  a  woman  gives  birth  to  a  child  of  defective  eye- 
sight ;  by  bathing  or  smearing  her  body  (with  sandal 
paste  etc.)  a  miserable  one  ;  by  anointing  her  body 
a  leper  (Kushthi)  ;  by  paring  her  nails  a  child  with  bad 
nails  ;  by  running  a  restless  one  ;  by  indulging  in  ex- 
cessive laughter,  a  child  with  brown  (S>ava)  teeth  or 
palate  or  tongue  ;  by  excessive  talking  a  garrulous 
child  or  one  of  incoherent  speech  ;  by  hearing  loud 
sounds,  a  deaf  child  ;  by  combing  her  hair,  a  bald  one  ; 
whereas  by  exposure  to  the  wind  or  by  doing 
fatiguing  work  (during  the  first  three  days  of  her 
period)  she  gives  birth  to  an  insane  child  (conceived 
immediately  after  it >.  Hence  these  acts  (day sleep  etc) 
arc  to  be  avoided.     24 

Regimen  to  be  observed  in  her 

menses  :  —A  woman  in  her  menses  should  lie  down 
on  a  matress  made  of  Kits' a  blades  (during  the  first  three 
days  of  her  uncleanness),  should  take  her  food  from,  her 
own  blended  palms  or  from  earthen  sauces,  or  from  trays 
made  of  leaves.  She  shonld  live  on  a  course  of  Habishya 
diet  and  forswear  during  the  time,  even  the  sight  of  her 
husband.  After  this  period,  on  the  fourth  day  she  should 
take  a  ceremonial  ablution,  put  on  a  new  (untorn) 
garment  and  ornaments  and  then  visit  her  husband  after 
having  uttered  the  words  of  necessary  benediction  25. 
Metrical  Text  :— A  child  conceived  after  the 
period  resembles  the  man  whom  she  first  sees  after 
ablution  on  the  fourth  day  of  her  menses  ;  hence  she 
should  see  none  but  her  husband*  at  that  time  (so  that 
the  child  may  resemble  his  father).  After  that  the 
priest  shall  perform  the    rites    (Garbhadhana  ceremony), 

*  In  the  case  of  the  hubband  being  absent  at  the  time,  she  should  look 
at  the  sun. 


128.  THE   SUSHRUTA    SAMKtlTA.  [Chap.  it. 

to  help  the  conception  of  a  male  child  and  after  the 
ceremony  a  wise  husband  should  observe  the  following 
rules  of  conduct.     26 — 27. 

Conduct  of  Husband  :— A  husbaud  wish- 
ing to  beget  a  son  by  his  wife,  should  not  visit  her  bed 
for  a  month  (before  the  day  of  the  next  flow).  Then  on 
the  fourth  day  of  her  uncleanness,  he  should  anoint  or 
lubricate  his  body  with  Ghrita,  should  partake  of  a  food 
in  the  afternoon  or  evening  composed  of  boiled  S^ctli  rice, 
milk  and  clarified  butter,  and  then  visit  the  bed  of  his 
wife  The  wife  also,  in  her  tern,  should  observe  a  similar 
vow  of  sexual  abstinence  (Brahma-charini)  for  a  month 
before  that  day  on  which  she  should  anoint  or  lubricate 
her  body  with  oil,  partake  of  food  largely  composed 
of  oil  and  Masha  pulse,  and  then  meet  her  husband 
at  night.  The  husband  then  having  uttered  the  appro- 
priate Veda  Mantras  and  having  awakened  confidence 
in  the  wife,  should  go  unto  her  on  the  fourth,  sixth, 
eighth,  tenth  or  on  the  twelfth  night  of  her  menses  for 
the  progenation  of  a  male  child.     28. 

IVIetrical  Text  ;— A  visit  to  the  wife  on  any 
of  these  nights  leads  to  the  continual  increase  of  the 
wealth,  progeny,  and  the  duration  of  the  husband's  life. 
On  the  other  hand,  a  visit  to  one's  wife  on  the  fifth, 
seventh,  ninth,  or  eleventh  day  of  her  flow  leads  to  the 
conception  of  a  female  child  The  thirteenth  and  the 
remaining  days  (till  the  next  course)  are  condemned 
as  regards  intercourse.     29—30 

Prohibited  Period  etc.  :— A  going  unto 

one's  wife  on  the  first  day  of  her  monthly  course  tends  to 
shorten  one's  life  and  a  child  born  of  the  act  dies  imme- 
diately after  its  delivery.  The  same  result  is  produced 
by  a  visit  on  the  secontl  day,  or  the  child  dies  lying-in 
locm  i.e.  ten  days  of  its  birth  ;  A  visit  on  the  third   day 


Chap,  n.j  SARIRA  STHANAM.  1 29 

leads  to  the  child's  being  deformed  and  short-lived.  A 
child  which  is  the  fruit  of  a  visit  on  the  fourth  day  lives 
long,  will  be  well  developed  and  remain  in  the  full  vigour 
of  health.  The  semen  cast  in  the  womb  of  a  woman 
during  the  continuance  of  her  monthly  flow  does  not 
become  fruitful  because  it  is  carried  back  and  flows  out 
in  the  same  manner  as  a  thing  thrown  into  a  stream  does 
not  go  against  but  is  carried  away  with  the  current. 
Hence  a  husband  should  foreswear  the  company  of  his 
wife  during  the  first  three  days  of  her  uncleanness,  when 
she  also  should  observe  a  vow  of  sexual  abstinence  ;  the 
husband  should  not  visit  his  wife  within  the  month  'after 
the  twelfth  day  of  her  menses).     31. 

After  the  impregnation  on  any  of  these  nights,  three 
or  four  drops  (of  the  expressed  juice)  of  any  of  the 
following  drugs  such  as  Lakshand,  Vata-S'unga! , 
S'ahadevd  or  Vis'vadevd,  mixed  with  milk  should  be 
poured  into  the  right  nostril  of  the  enceinte  for  the 
conception  of  a  male  child  and  care  should  be  taken 
that  she  does    not  spit  it  away.     32, 

lYIetrical  Text :— A  co-ordination  of  the  four 
factors  of  menstrual  period  (Ritu),  healthy  womb 
(Kshetra),  nutrient  liquid  le.  chyle  of  digested  food 
(Ambu),  healthy  semen  (Vija)  and  the  proper  observance 
of  the  rules  is  necessary  for  the  conception  and  develop- 
ment of  a  healthy  child  just  as  the  proper  season 
(Ritu),  good  soil  (Kshetra),  water  (containing  nutrient 
matter)  and  vigorous  seeds  (Vija)  together  with  proper 
care,  help  the  germination  of  strong  and  undiseased 
sprouts.  A  child  which  is  the  fruit  of  such  conception 
is  destined  to  be  beautiful,  of  vigorous  health,  generous, 
long-lived,  virtuous,  attached  to  the  good  of  its 
parents  and  capable  of  discharging  its  parental  obliga- 
tions. 33. 

17 


130  THE   SUSHRUTA  SAMHItA.  [Chap.  tl. 

Causes  of  different  colours  of  the 
Child:— The     fiery    principle    (Teja-dhaitu)   of    the 

organism,  which  is  the  originator  of  all  colours  of  the 
skin  (complexion),  happening  to  mix  largely  with  the 
watery  principle  of  the  body  at  the  time  of  conception, 
serves  to  make  the  child  a  fair  complexioned  one 
(Gaura-varna)  ;  mixed  with  a  large  quantity  of  the 
earth  principle  (Kshiti)  of  the  body,  it  makes  the  chiid  a 
dark  complexioned  one  (Krishna-varna).  In  combi- 
nation with  a  large  quantity  of  earth  and  ethereal 
principles  of  the  organism,  it  imparts  a  dusky  (Krishna- 
syama)  complexion  (to  the  full  developed  fcetus).  A 
similar  combination  of  watery  and  ethereal  principles 
serves  to  make  the  child  dusky  yellow  (Gaura-syama). 
Others  on  the  contrary  aver  that  the  complexion  of  the 
child  is  determined  by  the  colours  of  the  food  taken 
by  its  mother  during  the  period  of  gestation.     34. 

A  child  is  born  blind  in  the  failure  of  the  fiery 
principle  (Teja-dhatu)  of  the  organism  in  reaching  the 
region  of  its  still  undeveloped  eyes  (part — where  the 
eyes  would  be) ;  so  also  a  penetration  by  the  same 
(Teja-dhatu)  into  its  blood  accounts  for  the  blood-shot 
eyes  of  the  child.  Entered  into  the  Pittam  it  makes 
the  child  a  yellow-pupiled  one  (Pingalaksha).  Entered 
into  its  bodily  Kapham  it  makes  it  a  white-eyed  body 
and  mixed  with  its  bodily  Viyu,  a  child  of  defective 
eyesight.     35. 

Memorable  verses:— As  a  lump  of  con- 

densed  clarified  butter  melts  and  expands  if  placed  by 
the  side  of  a  fire,  so  the  ovum  (Artava)  of  a  woman  is  dis- 
lodged and  glides  away  in  contact  with  an  adult  male*. 

*  Sus'iula's  theory  is  that  ovulation  occurs  about  the  same  time  as 
menstruation  and  rather  initiates  the  latter,  and  the  shed  ova  are  washed 
out  wiih  the  menstrual  flow,  hence  there  is  a  possibility  of  conception  on 


Chap.  II.]  SARIRA   STHANAM.  I31 

A  seed  divided  into  two  by  the  deranged  Vayu  within 
the  (cavity  of  the)  uterus  (Kukshi)  gives  rise  to  the  birth 
of  twins,  conditioned  by  the  good  or  evil  deeds  of  their 
prior  existence  *  A  child  born  of  scanty  paternal 
sperm  becomes  an  Asekya  and  feels  no  sexual  desire 
(erection)  without  previously  (sucking  the  genitals  and) 
drinking  the  semen  of  another  man.  A  child  begotten 
in  a  sordid  vagina  is  called  a  Sougandhika,  whose 
organ  does  not  respond  to  the  sexual  desire  without 
smelling  the  genitals  of  others.  The  man  who  first  be- 
comes a  passive  member  of  an  act  of  sodomy  and  then 
again  commits  sodomy  with  the  woman  (he  visits)  is 
called  a  Kumbhika  (or  Guda-yoni  and  is  included 
within  the  category  of  a  Kliva).     2>^ — 40. 

The  man  who  cannot  copulate  with  a  woman  without 
previously  seeing  the  sexual  intercourse  of  another  couple 
is  called  Irshaka.  A  child  born  of  an  act  of  fecund- 
ation foolishly  or  ignorantly  effected  during  the  menses 
of  its  mother  by  its  progenitor  by  holding  her  on  his 
bosom  during  the  act  is  called  a  Shanda  and  invariably 
exhibits  effeminate  traits  in  his  character.  A  daughter 
born  of  a  woman  riding  on  her  husband  during  the  act 
of  sexual  intercourse  will  develop  masculine  traits  in 
her  character.     41 — 43. 

connexion  during  the  period  of  flow.  But  when  the  menstruation 
stops  of  itself  by  the  end  of  the  third  day,  it  also  indicates  that 
ovulation  has  ceased  and  no  ovum  is  left  to  be  fertilized,  hence  the 
question  arises  how  can  there  be  conception  then  on  connexion  on  the 
fourth  day  and  thereafter  ?  The  explanation  (as  in  the  following  verse) 
is  that  the  ovulating  organ  though  quiescent  at  the  time  is  again 
stimulated  to  activity  by  intercourse  with  a  male  and  new  ova  are  shed 
which  are  ready  to  be  fertilized  by  the  semen. — Ed. 

*  Gayi  interprets  the  term  **Dharmetara"  to  mean  evil  deeds  (other 
than  good)  and  quotes  verses  from  S'rutis,  S'mritis  and  Tantras  on  ex- 
piations of  sin  in  support  of  his  view. 


j?,2  THE  SUSHRUTA  SAMHITA  [Chap.    II. 


w' 


Semen  is  developed  in  the  four  types  of  Kliva 
known  as  Asekya,  Sougandhika,  Kumbhikaand  Irshaka, 
whereas  a  Shanda  is  devoid  of  that  fluid  (Sukra). 
The  semen  carrying  ducts  of  an  Asekya  etc.  are  ex- 
panded by  the  drinking  of  the  semen  as  above  described 
which  helps  the  erection  of  his  reproductive  organ.  44-45 

The  conduce  and  character  of  a  child  and  its  incli- 
nation to  particular  dietary  are  determined  by  those  of 
its  parents  during  the  act  of  fecundation.  A  boneless 
{i,  e.  with  cartilaginous  bones)  monstrosity  is  the 
outcome  of  the  sexual  act  in  which  both  the  parties  arc 
female  and  their  Sukra  (sexual  secretion)  unite  some 
how  or  other  in  the  womb  of  one  of  them.  Fecundation 
may  take  place  in  the  womb  of  a  woman,  dreaming  of 
sexual  intercourse  in  the  night  of  her  menstrual  ablution. 
The  local  Vayu  carries  the  dislodged  ovum  into  the  uterus 
and  exhibits  symptoms  of  pregnancy,  which  develop 
month  after  month  till  the  full  period  of  gestation.  The 
offspring  of  such  a  conception  is  a  Kalala  (a  thin  bone- 
less jelly-like  mass)  on  account  of  the  absence  of  the 
paternal  elements*  in  its  development.  Such  monstro- 
sities as  serpents,  scorpions,  or  gourd  shaped  foetus 
delivered  from  the  womb  of  a  woman  should  be  ascribed 
as  the  effects  of  deadly  sins.     46-49. 

The  child  of  a  mother  whose  wishes  are  not  honoured 
and  gratified  during  pregnancy  stands  in  danger  of  being 
bom  palmless,  hunchbacked,  lame,  dumb  or  nasal 
voiced  through  the  deranged  condition  of  the  Vdyu  of 
its  mother's  body.  The  malformation  of  a  child  in  the 
womb  should  be  ascribed  to  the  atheism  of  its  parents, 
or  to  the  effects  of  their  misdeeds  in  a  prior  existence,  or 

*  Hair,  beard,  nails,  teeth,  arteries,  veins,  ligaments  and  semen  are 
called  paternal  elements  inasmuch  as  these  are  said  to  be  inherited  by 
tlje  child  from  its  fj^ther 


Chap.  II.]  SARIRA    STHANAM.  I33 

to  the  aggravated  condition  of  the  Vayii,  Pittam  and 
Kapham.     50  —  51. 

A  foetus  in  uterus  does  not  excrete  faeces  or  urine, 
owing  to  the  scantiness  of  the  fecal  matter,  etc ,  in  its 
intestines  and  also  to  the  obstruction  and  consequently 
lessened  admission  of  the  Vayu  into  its  lower  bowels. 
A  child  in  the  womb  does  not  cry  inasmuch  as  its 
mouth  remains  covered  with  the  sheath  of  the  placenta 
i.e.  foetal  membranes  (Yarau)  and  its  throat  is  stuffed  with 
Kapham.  The  processes  of  respiration,  sleeping  and 
movement  of  the  foetus  in  the  womb  are  effected  through 
those  of  its  mother.     52  —  53. 

The  adjustment  of  the  different  limbs  and  organs 
of  the  body  of  a  child  in  the  womb  at  their  proper 
places,  the  non-development  of  hair  on  its  palms  and  soles 
and  the  subsequent  cutting  and  falling  off  of  its  teeth  are 
spontaneously  effected  according  to  the  laws  of  nature 
after  the  model  of  its  own  species.  An  honest,  pious, 
erudite  man,  who  has  acquired  a  vast  knowledge  of 
the  Sastras  in  his  prior  existence,  becomes  largely 
possessed  of  mental  traits  of  the  Sdttvika  stamp  in 
this  life  too  and  also  remembers  his  prior  births 
(Jatismara).  Acts  similar  to  those,  which  a  man 
performs  in  a  prior  existence,  overtake  him  also  in  the 
next.  Similarly  the  traits  and  the  temperament  which 
he  had  developed  in  a  previous  existence  are  likewise 
sure  to  be  patent  in  the  next.     54—55- 

Thus  ends  the  second  Chapter  of  the  S'arira  Sthanam    in    ihe    Sus'ruta 
Samhila  which  treats  of  the  purification  of  sperm  and  ovum. 


CHAPTER  III. 

Now  we  shall  discourse  on  the  Sariram  which  treats  of 

pregnancy,  etc.  (Garbha  Yakrant i  ^ari ram),  i. 

The  male  reproductive  element  (Sukra)  is  endowed 
with  Soma-guna  (i.e  ,  thermolytic  properties)  the  female 
element  Artava)  presents  the  opposite  property  and  is 
therefore  Agni-guna  (i  e.,  thermogenetic  properties). 
The  principles  of  earth,  water,  fire:,  air  and  ether  are  also 
present  in  men  in  their  subtile  forms  and  contribute  to 
the  formation  of  the  material  parts  by  their  molecular 
adjustment  in  the  way  of  supplying  nutrition  and  in 
way  of  the  adding  to  their  bulk.     2. 

Combination  of  Self  with  the  im- 
pregnated matter  :— The  local  Vdyu  (nerve- 
force)  heightens  or  aggravates  the  heat  generated  by 
the  friction  of  the  sexual  organs  in  an  act  of  copula- 
tion. The  Vdyu  and  heat  thus  aggravated  tend  to  dis- 
lodge the  semen  from  its  sac  or  receptacle  in  a  man 
which  enters  into  the  uterus  of  a  woman  through  the 
vaginal  canal  and  there  it  mixes  with  the  ovum 
(Artavam)  dislodged  and  secreted  by  similar  causes. 
The  combined  ovum  and  semen  are  subsequently  con- 
fined in  the  uterus  vGarbhclsaya).  After  that,  He  who 
is  known  by  the  epithet;  of  Self-conscious,  impressioner 
(creator  of  sensations  and  perceptions),  toucher,  smeller, 
seer,  hearer,  taster.  Self  or  Ego,  creator,  wanderer,  wit- 
ness, ordainer,  speaker,  though  eternal,  unmanifested 
and  incomprehensible  in  his  real  nature,  takes  hold  of 
the  five  subtile  or  essential  material  principles  contributed 
by  the  united  impregnating  matter,  assumes  a  subtile 
shape  throughout,    marked    by   the   three   fundamental 


Chap.  III.]  SARIRA  STHANAM.  1 35 

qualities  of  Sattva,  Rajas  and  Tamas,  and  led  away  by 
the  Vayu,  lies  confined  in  the  uterus  to  be  subsequently 
evolved  out  in  the  shape  of  a  god,  animal,  or  monster, 
as  determined  by  his  acts  in  the  former  existence.     3. 

Factors  which  determine  sex  :— The 

birth  of  a  male-child  marks  the  preponderance  of  semen 
over  the  ovum  (in  its  conception) ;  the  birth  of  a 
daughter  shows  the  preponderance  of  the  maternal  ele- 
ment. A  child  of  no-sex  (hermaphrodite)  is  the  product 
when  ovum  and  sperm  are  equal  (in  their  quality  and 
quantity).  The  first  twelve  nights  after  the  cessation 
of  the  flow  should  be  deemed  as  the  proper  period  for 
conception,  as  being  the  time  during  which  the  ova  are 
secreted.  Certain  authorities  hold  that  there  are  women 
who  never  menstruate  to  all  appearances      4 — 5. 

IVlemorable  verses  :— The  face  of  a  woman 
(lit :  a  woman  of  undetected  menstruation)  becomes 
full  and  lively.  A  moist  and  clumsy  deposit  is  found 
on  the  body,  face,  teeth  and  gums.  She  feels  a 
desire  for  sexual  intercourse  and  speaks  sweet  words. 
Her  eyes,  hair,  and  belly  droop  down.  A  sort  of 
distinct  throbbing  is  felt  in  her  aims,  thighs,  mammse, 
umbilicus,  perineum  and  buttocks.  Her  sexual  desire 
grows  intense  and  prominent,  and  its  gratification  gives 
her  utmost  joy  and  pleasure.  These  symptoms  will  at 
once  indicate  that  a  woman  has  menstruated  (inter- 
nally).    6. 

Just  as  the  petals  of  a  full  blown  lotus  flower  are 
gathered  up  during  the  night,  so  the  uterus  (Yoni)  of  a 
woman  is  folded  up  {i.  e.,  os  of  the  uterus  is  closed)  after 
the  lapse  of  the  menstrual  period  {ie.  fifteen  days  from  the 
date  of  the  flow).  The  menstrual  flow,  accumulated  in 
the  course  of  a  month,  is  led  in  time  by  the  local  Vayu 
through   its   specific   duct   (Dhamani)  into  the  mouth  of 


136  THE   SUSHRUTA  SAMIIITA.  [Ch&p.  III. 

the  uterus  (Yonij  whence  it  flows  out  odourless  and 
blackish,     7. 

Period  of    IVIenstruation  :— The   process 

(menstruation)  commences  at  the  twelfth  year,  flowing 
once  in  every  month,  and  continues  till  the  fiftieth*  year 
when  it  disappears  with  the  sensible  decay  of  the  body.  8 

A  visit"!-  to  one's  wife  on  even  days  during  the  cata- 
menial  period  (twelve  days  in  all  from  the  cessation  of 
the  flow)  leads  to  the  conception  of  a  male  child  while 
an  intercourse  on  odd  days  results  in  the  birth  of  a 
daughter.  Hence  a  man,  seeking  a  male-issue,  should 
approach  his  wife  for  the  purpose  in  a  clean  body  and 
with  a  quiet  and  calm  spirit  on  an  even  date.     9. 

A  sense  of  fatigue  and  physical  languor,  thirst, 
lassitude  and  weariness  in  the  thighs,  suppression  of  the 
flow  of  semen  and  menstrual  secretion  (Sukra  and 
Sonita)  out  of  the  uterus  (Yoni),  and  throbbing  in  the 
organ  /Rafter  coition)  are  symptoms  of  a  recent  fecun- 
dation.    lO. 

Signs   of    Pregnancy-(M.  T.  :— A  black 

rash  (areola)  around  the  nipples  of  the  mammae,  the 
rising  appearance  of  a  row  of  hair  (as  far  as  the  umbilicus), 
contractions  of  the  eye-wings,  sudden  vomitings,  nausea 
which  does  not  abate  even  on  smelling  perfumes,   water- 

*  Some  are  of  opinion  that  the  menstruation  continues  up  to  the 
sixtieth  year. 

t  According  to  Videha,  menstrual  secretion  flows  less  on  even 
days,  hence  a  son  is  born  if  the  sexual  intercourse  be  made  on  those 
days  ;  whereas  menstrual  secretion  becomes  more  on  odd  days,  so  a 
daughter  is  born  if  the  intercourse  be  made  on  odd  days. 

According  to  Bhoja,  a  son  is  born  from  intercourse  on  even  days  and 
a  daughter  is  born  from  that  on  odd  days.  The  birth  of  a  male  issue  is 
due  to  the  preponderance  of  semen  virile  and  that  of  a  female  sex  is  due 
to  the  preponderance  of  menstrual  secretion.  If  both  the  secretions  be 
equal  (in  quality  and  quantity)  a  hermaphrodite  is  issued. 


Chap.  III.]  SARIRA  STHANAM. 


13; 


brash,  and  a  sense  of  general  lassitude  are  the  indications 
of  pregnancy,     ri. 

Prohibited  conducts  during  gesta- 
tion : ^Immediately  on  the  ascertainment  of  her 
pregnancy,  a  woman  should  avoid  all  kinds  of  physical 
labour,  sexual  intercourse,  fasting,  causes  of  emaciation 
of  the  body,  day-sleep,  keeping  of  late  hours,  indulgence 
in  grief,  fright,  journey  by  carriage  or  in  any  kind  of 
conveyance,  sitting  on  her  haunches,  excessive  appli- 
cation of  Sneha-karmas  etc.,  and  venesection  at  an 
improper  time  {i.e ,  after  the  eighth  month  of  gestation), 
and  voluntary  retention  of  any  natural  urging  of  the 
body.     12. 

IVIetrical  Text  :— The  child  in  the  womb  feels 
pain  in  the  same  part  of  its  body  as  the  one  in  which 
its  mother  feels  any  ;  whether  this  (pain)  may  be  from 
an  injury  or  through  the  effect  of  any  deranged  morbific 
principle  (Dosha)  of  her  organism.     13. 

Development  of  the  Foetus:— In  the  first 

month  of  gestation  a  gelatinous  substance  is  only 
formed  (in  the  womb) ;  the  molecules  of  the  primary 
elements  (Mahabhuta — air,  fire,  earth,  water,  and  ether) 
being  acted  upon  by  cold  (Kapham\  heat  (Pittam)  and 
air  (Vdyu  or  nerve-force)  are  condensed  in  the  second 
month.  A  lump-like  appearance  (of  that  confused 
matter)  indicates  the  male-sex  (of  the  embryo).  An 
elongated-like  shape  of  the  matter  denotes  that  the 
foetus  belong  to  the  opposite  sex  ;  whereas  its  tumour- 
like shape  (like  a  Salmali-bud)  predicts  the  absence  of 
any  sex  {i  e,  a  hermaphrodite),  In  the  third  month, 
five  lump-like  protuberances  appear  at  the  places  where 
the  five  organs  —namely  the  two  hands,  two  legs  and  the 
head — would  be  and  the  minor  limbs  and  members  of 
the   body    are   formed    in    the  shape  of  extremely  small 


138  THE   SUSHRUTA   SAMHITA.  [Chap.  III. 

papillae.  In  the  fourth  month  all  the  limbs  and  organs 
(of  the  body  of  the  embryo)  become  more  potent  and 
the  foetus  is  endowed  with  consciousness  owing  to  the 
formation  of  viscus  of  the  heart.  As  heart  is  the  seat 
of  consciousness,  so  a?  the  heart  becomes  potent,  it  is 
endowed  with  consciousness  and  hence  it  expresses  its 
desire  for  things  of  taste,  smell  etc.  (through  the 
loneincfs  of  its  mother).  The  enciente  is  called  double- 
hearted  (Dauhrida)  at  the  time,  whose  wishes  and 
desires — not  being  honoured  and  gratified — lead  to  the 
birth  of  a  paralysed,  hump-backed,  crooked -armed, 
lame,  dwarfed,  defect-eyed,  and  a  blind  child.  Hence 
the  desires  of  the  enciente  should  be  gratified,  which 
would  ensure  the  birth  of  a  strong,  vigorous  and  long- 
lived  son.     14. 

IVlemorable  Verses  :— A   physician  should 

cause  the  longings  of  a  pregnant  woman  (Dauhrida) 
to  be  gratified  inasmuch  as  such  gratifications  would 
alleviate  the  discomforts  of  gestation  ;  her  desires  being 
fulfilled  ensure  the  birth  of  a  strong,  long-lived,  and 
virtuous  son.  A  non-fulfilment  of  her  desires  during 
pregnancy,  proves  injurious  both  to  her  child  and  her 
ownself.  A  non-gratification  of  any  sensual  enjoy- 
ment by  its  mother  ;Dauhrida)  during  gestation  tends 
to  painfully  afTect  the  particular  sense-organ  of  the 
child. 

Longings     and     its   effects   during 

pregnancy  : — An  enciente  longing  for  a  royal 
interview  during  her  gestation  (fourth  month)  gives 
birth  of  a  child,  who  is  sure  to  be  rich  and  to  hold  a 
high  position  in  life  Her  longing  for  fine  silks, 
clothes,  ornaments  etc.  indicates  the  birth  of  a  beauti- 
ful child  of  aesthetic  taste.  The  birth  of  a  pious  and 
self-controlled  child  is  indicated  by  its  mother's   longing 


Chap.  III.]  SARIRA   STHANAM, 


39 


for   a    visit    to    a   hermitage.     The  desire  of  a  pregnant 
woman  to  see  a  divine   image   or   an    idol,  predicts   the 
birth  of  a  child  in  her  womb  who  would  grace  the  council 
of  an    august  assembly    in    life.     Similarly,    a  desire  to 
see  a   savage   animal  on  the  part  of  a  pregnant   woman 
signifies  the   presence    of  a    child    of  savage    and    cruel 
temperament    in  her  womb.     A  desire  for    the  flesh  of  a 
Godha  indicates  the  presence  of  a  sleepy,  drowsy  person 
in  her  womb  who  would    be   tenaciously   fond    of  good 
things    in    life.     Similarly    a    longing    for    beef  on    the 
part  of  the  mother  (during  gestation)  indicates  the  birth 
of  a   strong   and    vigorous    child    capable   of  sustaining 
any  amount  of  fatigue    and  physical  pain      A    longing 
for   bufifalo-meat  of  the  mother  indicates  the    birth  of  a 
hairy,   valiant   and    red-eyed     child  (in    her   womb);    a 
longing   for   boar-flesh    indicates  the    birth  of  a  drowsy 
child   though    valiant  ;  a   longing   for  venison  indicates 
that   of  an    energetic,   determined    and    sylvan-habited 
child  ;   a  longing  for    Srimara-meat  indicates    that   of  a 
distracted  person  ;    a    longing    for   the  flesh  of  Tittira 
bird    indicates    that    of    a    child    of  timid    disposition  ; 
whereas   a  desire   on    the   part    of  an  enciente  for   the 
flesh   of  any   particular  animal  indicates  that  the  child 
in   the   womb   would    be    of     such    stature    and    would 
develop  such  traits  of  character    in    life   as    are  peculiar 
to   that   animal.     The  desires    of  a    woman  during  her 
pregnancy  are  determined  by    ordained  fate   and    effects 
of  the  acts  of  the  child  in  its  prior  existence  (that  are  to 
be  happened  during  the  present  life).     15. 

Development   of  the  FcBtus  s— In  the 

fifth  month  the  foetus  is  endowed  with  mind  (Manah^ 
and  wakes  up  from  the  sleep  of  its  sub-conscious  exis- 
tence. In  the  sixth  month  cognition  (Buddhi)  comes 
in.    In  the  seventh  month  all  the  limbs  and   members 


I40  THE  SUSHRUTA  SAMHITA.  [Chap.  III. 

of  its  body  are  more  markedly  developed.  The  Ojo- 
dhdtu  (in  the  heart  of  the  foetus)  does  not  remain  silent 
in  the  eighth  month  *  A  child  born  at  that  time  (eighth 
month)  dies  for  want  of  Ojo-dhatu  soon  after  its  birth, 
a  fact  which  may  be  equally  ascribed  to  the  agency  of 
the  malignant  monsters.  Hence  (in  the  eighth  month  of 
gestation)  offerings  of  meat  should  be  made  to  the  demons 
and  monsters  (for  the  safe  continuance  of  the  child). 
The  parturition  takes  place  either  in  the  ninth,  tenth, 
eleventh  or  twelfth  month  of  conception,  otherwise 
something  wrong  with  the  foetus  should  be  appre- 
hended.    i6. 

The  umbilical  chord  (Nadi)  of  the  foetus  is  found  to 
be  attached  to  the  cavity  of  the  vein  or  artery  of  its 
maternal  part  through  which  the  essence  of  lymph-chyle 
(Rasa)  produced  from  the  assimilated  food  of  the 
mother,  enters  into  its  organism  and  fastens  its  growth 
and  development,  (a  fact  which  may  be  understood  from 
the  analogy  of  percolation  or  transudation  of  blood). 
Immediately  after  the  completion  of  the  process  of 
fecundation,  the  vessels  (Dhamani)  of  its  maternal  body 
which  carry  the  lymph-chyle  (Rasa)  and  run  laterally  and 
longitudinally  in  all  directions  through  it,  tend  to  foster 
the  foetus  with  their  own  transudation  all  through  its 
continuance  in  the  womb.     17. 

Different  opinions  on  the  formation 
of  the  foetal  body  :— Saunaka  says  that 
probably  the  head  of  the  foetus  is  first  developed 
since  head  is  the  only  organ  that  makes  the  functions 
of  all  other  organs  possible.  Kritaviryya  says,  it  is 
the  heart  that  is  first  developed  since  heart  is  the  seat 
of  Manah  and  Buddhi  (mind  and  intellect).     The  son    of 

*  Sometimes   it    passes   from   the   body  of  the   child   to   that  of  the 
mother  and  vice  versa. 


Chap.  III.]  SARIRA   STHANAM.  I4I 

Para'sara  says  that  the  development  of  the  umbilical  re- 
gion of  foetus  must  necessarily  precede  (that  of  any  other 
part  of  its  body)  inasmuch  as  it  is  through  umbilical 
chord  that  an  embryo  draws  its  substance  from  mother's 
body.  Matrkandeya  says  that  the  hands  and  feet  of  a 
fcetus  are  first  te  be  developed  since  they  are  the  only 
means  of  movements  in  the  womb.  Subhuti  Gautama 
says  that  the  development  of  the  trunk  is  the  earliest  in 
point  of  time  since  all  other  limbs  and  organs  lie  solder- 
ed to  and  imbedded  in  that  part  of  the  body.  But  all 
these  are  not  really  the  fact.  Dhanvantari  holds  that  the 
development  of  all  the  parts  of  the  body  of  an  embryo 
goes  on  simultaneously  ;  and  they  can  not  be  perceived 
or  detected  in  their  earlier  stages  of  development  in  the 
womb  owing  to  their  extremely  attenuated  size  like  a 
mango  fruit  or  sprouts  of  bamboo.  As  the  stone,  marrow, 
pith  etc.  of  a  ripe  and  matured  mango-fruit  or  the 
sprouts  of  bamboo,  cannot  be  separately  perceived  in 
the  earlier  stage  of  their  growth  but  are  quite  distin- 
guishable in  the  course  of  their  development,  likewise 
in  the  early  stage  of  pregnancy  the  limbs  and  organs  of 
the  body  (foetus)  are  not  perceptible  for  their  extremely 
attenuated  stage  but  become  potent  (and  therefore  they 
are  distinctly  perceived)  in  the  course  of  time  for  their 
development.     18. 

Factors  respectively  supplied  by  the 
paternal  and  maternal  elements  :-Now 

we  shall  describe  the  parts  and  principles  of  the 
body  of  a  foetus  which  are  respectively  contributed  by 
the  paternal  element,  maternal  factor,  the  serum 
(Rasaja),the  soul  (Atmaja),  the  natural  (Sattvaja)  and  the 
innate  physiological  conditions  (Satmyaja).  The  hairs 
of  the  head  and  body,  beard  and  moustaches,  bones, 
nails,   teeth,    veins    (Sira),    nerves,  arteries   (Dhamani), 


142  THE   SUSHRUTA    SAMHITA.  [Chap.  III^ 

semen  and  all  the  steady  and  hard  substances  (in 
the  organism  of  a  child)  are  contributed  by  the 
paternal  element  in  the  conception  Pitraja  ;  whereas 
flesh,  blood,  fat,  marrow,  heart,  umbilicus,  liver,  spleen, 
intestines,  anus  (Guda)  and  all  other  soft  matters  in 
the  body  owe  their  origin  to  the  maternal  element 
(Matrija)  ;  strength,  complexion,  growth,  rotundity  and 
decay  of  the  body  are  due  to  the  serum  (Rasaja\ 
The  sensual  organs,  conciousness,  knowledge,  wisdom, 
duration  of  life  (longivlty),  pleasure  and  pain  etc.  are 
the  outcome  of  the  spiritual  element  in  man  (Atmaja). 
We  shall  describe  the  Sattvaja  features  of  the  body  in 
the  next  chapter.  Valour,  healthfulness,  strength,  glow 
and  memory  are  the  products  of  a  child  naturally 
born  with  physiological  conditions  of  the  parents 
(Sdtmyaja).     19. 

Signs  of  male  and  female  concep- 
tion : — An  enciente,  in  whose  right  mammae  the  milk 
is  first  detected,  who  first  lifts  up  her  right  leg  at  the 
time  of  locomotion,  whose  right  eye  looks  larger,  or 
who  evinces  a  longing  largely  for  things  of  masculine 
names,  dreams  of  having  received  lotus  flowers  (red 
and  white),  Utpala,  Kumuda,  Amrataka,  or  flowers  of 
such  masculine  denomination  in  her  sleep,  or  the  glow 
of  whose  face  becomes  brighter  during  pregnancy,  may 
be  expected  to  give  birth  to  a  male  child;  whereas 
the  birth  of  a  daughter  or  a  female  child  should  be 
pre-assumed  from  the  contriety  of  the  foregoing  indi- 
cations. An  enciente  whose  sides  become  raised  and 
the  forepart  of  whose  abdomen  is  found  to  bulge  out 
will  give  birth  to  a  sex-less  (hermaphrodite)  child.  An 
enciente,  the  middle  part  of  whose  abdomen  becomes 
sunk  or  divided  in  the  middle  like  a  leather-bag,  will 
give  birth  to  a  twin.    20. 


i 


Chfip.  ni-3  SARIRA   STHANAM.  I43 

lYIemorable  verses  :— Those  women  who 
are  devout  in  their  worship  of  the  gods  and  the 
BrAhmins  and  cherish  a  clean  soul  in  a  clean  body 
during  pregnancy  are  sure  to  be  blest  with  good, 
virtuous  and  generous  children  ;  whereas  a  contrary 
conduct  during  the  period  is  sure  to  be  attended 
with  contrary  fruits.  The  development  of  the  limbs 
and  the  members  etc.  of  a  foetus  in  the  womb  is  natural 
and  spontaneous,  and  the  qualities  and  conditions 
which  mark  these  organs  are  determined  by  the  acts 
of  the  child  which  arc  anterior  to  its  genesis  and  wcro 
done  in  its  prior  existence.     21-22. 

Thus  ends  the  third  Chapter  of  the  S'arira  Sihiinain    in   the   Su  'ru(a 
Samhita  which  treats  of  the  generation  and  pregnancy. 


CHAPTEE  IV. 

Now  we  shall  discourse  on  the  Sariram  which 
treats  of  the  development  of  a  fcetus  in  the  womb, 
as  well  as  of  the  factors  which  contribute  to  the  growth 
of  its  different  bodily  organs  and  principles  (Garbha- 

Vyakaranam-^gfriram).     i. 

The  Pittam  (fiery  or  thermogenic)  and  Sleshma 
(lunar  principles  of  the  body,  the  bodily  Vayu,  the  three 
primary  qualities  of  Sattva,  Rajas,  and  Tamas  (adhesion, 
cohesion  and  disintegration),  the  five  sense  organs,  and 
the  Self  (Karma-Purusha)  are  the  preserver  of  the  life 
(Prdnah)  of  the  Fcetus.     2. 

Folds  of  Skin  :  —Seven  folds  or  layers  of  cover- 
ing (Tvaka  — skin)  are  formed  and  deposited  on  the 
rapidly  transforming  product  of  the  combination  of 
(semen)  Sukra  and  Sonita  (fertilized  ovum)  which 
have  been  thus  charged  with  the  individual  Soul 
or  Self  in  the  same  manner  as  layers  (of  cream)  are 
formed  and  deposited  on  the  surface  of  (boiling)  milk. 
Of  these  the  first  fold  or  layer  is  called  Avabha'sini 
(reflecting)  as  it  serves  to  reflect  all  colours  and  is  cap- 
able of  being  tinged  with  the  hues  of  all  the  five  mate- 
rial principles  of  the  body.  The  thickness  of  this  fold 
measures  eighteen-twentieth  of  a  Vrihi^  (rice  grain)  and 
it  is  the  seat  of  skin  diseases,  such  as    Sidhma,   Padma- 

*  The  complexion  of  a  person  is  due  to  this  first  layer  ;  and  as  the 
colour  of  an  opaque  body  is  due  to  the  rays  that  are  reflected  from  its 
surface,  this  layer  is  rightly  named  Avabba^'ini  or  reflecting  layer. 

**  The  text  runs  "Vriherashtadashabhaga,"  which  means  eighteen  (or 
so  mnny)  parts  of  a  Vrihi  ;  and  Dalian  comments  that  "Vrihi"  stands  for 
a  measure  equal  to  the  twentieth  division  of  a  Vrihi  or  rice  grain. 


Chap,  IV.]  SARIRA   STHANAM.  I45 

kantaka  etc.  The  second  fold  (from  the  surface)  is 
called  Lohitai  ;  it  measures  a  sixteen-twentieth  of  a 
Vrihi  and  is  the  seat  of  such  (cutaneous  affections;  as 
Tilakilaka,  Nyachcha  and  Vyanga  etc.  The  third  fold 
or  layer  is  called  S'/^ti  which  measures  in  thick- 
ness, a  twelve-twentieth  of  a  Vrihi,  and  forms  the  seat 
of  such  diseases  as  Aj.igalli,  Charmadala,  and  Mas'aka 
etc.  The  fourth  fold  or  layer  is  called  Tstmrak 
measuring  an  eight-twentieth  of  a  Vrihi  and  forms 
the  seat  of  such  diseases  as  the  various  kinds  of  Kilasa 
and  Kushtha  etc.  The  fifth  fold  or  layer  is  called 
Vedini,  measuring  in  thickness  a  five-twentieth  of  a 
Vrihi  and  forms  the  seat  of  Kushtha,  Visarpa,  etc.  The 
sixth  fold  or  layer  is  called  Rohini,  which  is  of  equal 
thickness  as  a  Vrihi  (grain),  and  is  the  seat  of  Granthi, 
Apachi,  Arvuda,  SHpada  and  Gala-ganda  etc.  The 
seventh  fold  or  layer  is  called  Matasa-dhara(  twice  a 
Vrihi  in  thickness  and  is  the  seat  of  Bhagandara, 
Vidradhi,  and  Ars'a  etc.  These  dimensions  should  be 
understood  to  hold  good  of  the  skin  of  the  fleshy  parts 
of  the  body,  and  not  of  the  skin  on  the  forehead,  or 
about  the  tips  of  the  fingers,  inasmuch  as  there  is  a 
surgical  dictum  to  the  effect  that  an  incision  as  deep  as 
the  thickness  of  the  thumb  may  be  made  into  the 
region  of  the  abdomen  with  the  help  of  a  Vrihi-mukha 
(instrument).     3. 

The  Kala(s  too  number  seven  in  all  and  are  situated 
at  the  extreme  borders  (forming  encasement  and  support) 
of  the  different  fundamental  principles  (Dhatus)  of  the 
organism.     4. 

Memorable  Verses  :  — As  the  duramen  or 
core  of  a  piece  of  wood  or  stem  becomes  exposed  to  view 
by  cutting  into  it,  so  the  root  principles  (Dha'tus)  of  the 
body  may  be  seen  by  removing  the  successive    layers    or 

19 


146  THE  SUSHRUTA   SAMlilTA.  Chap.  IV. J 

tissues  of  its  flesh.  These  Kalds  are  extensively  supplied 
with  Snayus  (fibrous  tissues),  bathed  in  mucous,  and 
encased  in  a  membranous  covering.     5-6. 

lYIansadhara-Kala:  -  Of  these  Kalas,the  first 
is  named  Ma^nsadhara  (fascia),  in  the  contained  flesh 
(bodily  substance  of  the  Kala)  of  the  Sira  (veins),  Snayu 
(fibrous  tissues),  Dhamani  (arteiies)  and  other  Srotas 
(channels;  are  found  to  spread  and  branch  out.     7. 

lYlemorable  Verse  :  — As  the  roots  and  stems 
of  a  lotus  plant  respectively  situated  in  the  ooze  and 
water  (of  a  tank;,  do  si.nultaneously  grow  and  expand, 
so  the  veins  etc  situated  in  the  flesh,  grow  and 
ramify.     8. 

Raktadhara- Kala  : -The   second    Kald    is 

called  Raktat-dharai  (Vascular  tissue  of  the  blood  vessels 
etc.).  The  blood  is  contained  in  these  inside  the  flesh 
and  specially  in  the  veins  (Sira)  and  in  such  viscera  of 
the  body  as  the  liver  and  spleen.     9. 

IVIemorable  Verse:— As  a  piant  containing 
latex  in  its  tissues,  when  injured  or  pricked,  exudes 
milky  juice,  so  blood  oozes  out  instantaneously  on  the 
flesh  of  the  body  (supplied  with  the  Raktadhara-kala) 
being  injured.     10. 

lYIedadhara-Kala  :— The  third  Kald  is  called 
Medadharai  (adipose  tissue).  Meda  (fat)  is  present  (chiefly) 
in  the  abdomen  of  all  animals,  as  well  as  in  the  cartila- 
ges (small  bones).  The  fatty  substance  present  in  large 
bones  is  called  Majjai  (marrow),     ir. 

lYIemorable  Verse  :— Marrow  is  found  inside 
large  bones,  whereas  a  substance  similar  in  appearance 
and  found  inside  other  bony  structures  (cartilages)  should 
be  considered  as  Meda,  mixed  with  blood.  The  fats, 
present  in  purely  muscular  structures,  go  by  the  name 
of  Vassi  (muscle-fat).     12-13. 


[Chap.  IV.  SARIRA  STHANAM. 


147 


dleshmsLdhar^C-Kala  :— The  fourth  Kala  is 
called  Sleshmaidharai  (Synovial  tissues)  and  is  present 
about  all  the  bone-joints  of  animals.     14. 

IVIemorable  Verse  :  -As  a  wheel  easily  turns 
upon  a  well  greased  axle,  so  the  joints  moistened  by  the 
mucous  (Sleshma)  contained  in  these  sacs  admit  of  easy 
movements,     i^. 

Purishadhara-Kala  :— The   fifth    kala    is 

called  Purishadharai  and  being  situated  in  the  Kostha 
(abdomen)  serves  to  separate  the  faecal  refuse  in  the 
(Pakvasaya)  lower  gut  (from  other  ingested  matters).    16. 

Memorable  Verse  :  —This  Kala  extends  about 
the  liver,  upper  and  lower  intestines  and  other  abdominal 
viscera  and  keeps  the  foeces  in  the  lower  intestines  (Un- 
dukam)  separate  and  hence  is  called  Maladhara-kald    17. 

Pittadhara-Kala:— The  sixth  Kald  is  called 
Pittapharat-kalSL ;  it  holds  (the  chyme  derived  from)  the 
four  kinds  of  solid  and  liquid  foods  (in  the  Pitta-sthanam 
or  biliary  region;  propelled  from  the  stomach  (Amds'aya 
or  Grahani-Nadi)  and  on  its  way  to  the  (Pakasaya) 
intestines  (for  the  proper  action  of  the  digestive  juices 
upon  it)      18. 

IVIemorable  Verse  :— The  four  kinds  of  food, 

viz.  those  that  are  chewed,  swallowed,  drunk,  or  licked, 
and  brought  into  the  intestines  (Kostha)  of  a  man,  are 
digested  in  proper  time  through  the  heating  agency 
(action)  of  the  Pittam      19. 

^Ukradhara-Kala  :-Thc  seventh  Kala  is 
called  S'lkradharsi  (semen-bearing),  which  extends 
throughout  the  entire  body  of  all  living  creatures.     20. 

Memorable   Verse :  -The  physician  should 

know  that  like  fat  (Sarpi)  in  the  milk,  or  sugar  in  the 
expressed  juice  of  sugar-cane,  the  (seat  of)  semen  is  co- 
extensive with  the  whole  organism  of  a  man  (or  animal). 


148  THE  SUSHRUTA  SAMHITA.  [Chap.  IV. 

The  semen  passes  through  the  ducts  situated  about  two 
fingers'  breadth  on  either  side  (vas  deferens)  and  just 
below  the  neck  of  the  bladder  and  finally  flows  out 
through  the  canal.  The  semen  of  a  man  during  an  act  of 
sexual  intercourse  with  a  female  under  exhilaration 
comes  down  from  all  parts  of  his  body  owiiig  to  the 
extreme  excitement  (engendered  by  the  act).     21-33. 

The  orifices  of  the  Artava—  carrying  channels  (vessels 
of  the  uterine  mucosa)  of  a  pregnant  woman  are  ob- 
structed by  the  foetus  during  pregnancy  and  hence  there 
is  no  show  of  menses  (during  gestation).  The  menstrual 
blood  thus  obstructed  in  its  downward  course  ascends 
upwards ;  a  part  of  it  accumulates  and  goes  to  the 
formation  of  placenta  (Apara' ,  while  the  rest  ascends 
higher  up  and  reaches  the  breasts  ;  this  is  the  reason 
why  the  breasts  of  a  pregnant  woman  become  full  and 
plump.     24. 

The  spleen  and  liver  of  the  foetus  are  formed  out 
of  blood  ;  the  lungs  are  made  of  the  froth  of  the 
blood  ;  and  the  Unduka  or  faecal  receptacle,  of  the  refuge 
matter  (Mala)  of  the  blood.     25, 

Metrical  Texts  :— The  intestines  (Antra),  the 
bladder  (Vasti),  and  the  anus  (Guda)  of  the  foetus  are 
formed  out  of  the  essence  of  the  blood  and  Kapham, 
baked  by  the  Pittam  into  which  VAyu  enters  as  well. 
As  fire  fed  by  draughts  of  air  refines  the  dregs  of 
golden  ore  and  transforms  it  into  pure  metal,  so  blood 
and  Kapham  acted  upon  by  the  heat  of  the  Pittam 
are  transformed  into  the  shape  of  the  intestines  etc. 
in  the  abdomen.  The  tongue  is  made  of  the  essence 
of  the  flesh,  blood  and  Kapham.  The  Vdyu,  com- 
bined with  heat  (Pittam)  in  adequate  proportion,  rends 
through  the  internal  channels  into  the  flesh  and  trans- 
forms them  into  muscles  (Pesi).  The  Vdyu,  by  taking  off 


Chap.  IV.]  SARIRA  STHANAM.  149 

the  oily  principles  of  fat  (Meda),  transforms  them  into 
(Sirat'  and  (fibrous  tissues)  Sna^yu,the  underbaked  (Mridu) 
ones  being  converted  into  the  Sir^  and  the  overbaked 
(Kshara)  ones  into  the  Sndyu.  The  internal  cavities 
(As'ayas)  of  the  body  mark  the  spots  or  regions  where  the 
Vayu  had  constantly  stayed  in  its  embryo  stage.  26-29. 
The  kidneys  (Vrikkas)  are  made  out  of  the  essence 
of  the  blood  and  fat.  The  testes  are  formed  out  of  the 
essence  of  the  blood,  flesh,  Kapham  and  fat.  The  heart 
is  formed  out  of  the  essence  of  blood  and  Kapham  ; 
and  the  vessels  (Dhamanis)  carrying  the  vital  principles 
of  the  body  are  attached  to  it  (heart).  The  spleen  and  the 
lungs  are  situated  below  and  beneath  the  heart  on  the 
left  side,  and  the   liver    and    Kloma    (Pancreas  ?)  below 

and    beneath   it    (heart)    on  the  right.     The  heart  is  the 
special  seat  of  consciousness  (ChetaiiS^)    in  all  creatures. 

Sleep  sets  in  when  this  viscus   heart)  of  a  person  becomes 

enveloped  by   the    effects    of  the  Tamas  (principles    of 

illusion  or  nescience).     30-31. 

IVIemorable  Verse  S— The  heart    which   is  of 

the  shape  of  a  lotus  bud  hangs  with  its  apex   downward, 

folding   itself  up   during  sleep  and  expanding  with  the 

return  of  wakening  or  consciousness.     32. 

Sleep  and  its  virtues  :— Sleep  is  the  illu- 
sive energy  of  God  ^lit.  — the  all-pervading  deity;  and 
naturally  has  its  sway  over  all  created  beings.  The 
kind  of  sleep  which  sets  in  when  the  sensation-carrying 
channels  iSn^yu)  of  the  body  are  choked  by  Sleshma, 
which  abounds  in  the  quality  of  Tamas,  is  known  as 
Tatmasi-nidrai.  It  is  this  sleep  which  produces  uncon- 
sciousness at  the  time  of  dissolution  or  death.  A  man 
of  Tatrnxsika-temperament  sleeps  both  in  the  day  and 
night ;  one  of  the  Ra^asika-temperament  sleeps  either  in 
the  day  or  in   the   night ;  while   sleep   never   visits  the 


T50  THE   SUSIIRUTA  SAMHITA.  Chap.  IV.] 

eyelids  of  a  man  of  Sa^ttvika-temperament  before  mid- 
night. Persons  with  enfeebled  Kapham  and  aggra- 
vated Vayu,  or  suffering  from  bodily  and  mental  troubles, 
get  little  sleep,  and  if  at  all,  their  sleep  is  of  the  Vaika- 
rika  or  delirious  type  {i.e.  much  disturbed)*      33-34. 

IVIemorabIC  Verses  :  -O  SusVuta  !  the  heart  is 
said  to  be  the  primary  seat  of  consciousness  (Chetan^)  in 
the  animated  beings.     Sleep  overcomes  a  man    whenever 
the    heart   is    enveloped  in  the  illusive  effects  of  Tamas. 
Sleep  is  the  offspring  of  Tamas  and  it  is  the    quality   of 
Sattvam   that  brings   on  awakening.     This  is  the  funda- 
mental law  of  Nature.     The  self-conscious  individuality 
(Self),  ensconced    in    the   material   frame  of  man  which 
is   composed    of  the    five   material    elements,    recollects 
through  the  agency  of  the  mind  (Manah),  which  abounds 
in  the  quality  of  Rajas,  the    renaissance    of  his   by-gone 
existences,    and    wakens  up  in  his  psychic  plane  the  pic- 
tures of    good    or   evil    deeds     done     by     him    therein. 
Dreams   are   but   the  embodiment  of  these  recollections. 
The  self  or   Jivatmai,    though   he   sleeps  not  himself,  is 
said  to  be  sleeping,  whenever  the  sense  organs    are  over- 
powered by  the  illusive  energy  of  Tamas.     35. 

Day  sleep  is  forbidden  in  all  seasons  of  the  year, 
except  in  summer  and  in  the  case  of  infants,  old  men, 
and  persons  enfeebled  by  sexual  excesses,  or  in  Kshata- 
kshina  diseases  and  in  case  of  habitual  tipplers.  A  sleep 
in  the  day  may  be  enjoyed  after  the  fatigue  of  a  long 
journey,  riding,  or  physical  labour,  or  on  an  empty 
stomach.  It  may  be  allowed  as  well  to  men  suffering 
from    the    loss   of    fat,   Kapham   or   blood,   to  those    of 

*  Such  persons  may  get  sleep  only,  when  bting  tired  and  exhausted 
they  cease  to  think  of  their  affairs. 

C  f.  Charaka  :— When  the  active  self  of  a  person,  tired  in  body  and 
jnind,  loses  touch  with  his  worldly  affairs,  sleep  comes  to  him, 


Chap.  IV.]  SARIRA   STHANAM.  151 

scanty  perspiration,  or  of  dry  or  parched  constitution  ; 
and  also  to  those  who  have  been  suffering  from  indi^ 
gestion  and  who  may  sleep  for  a  Muhurta  (48  minutes) 
in  the  day  time.  Those  who  have  kept  late  hours  in 
the  night  may  sleep  in  the  day  for  half  the  time  they 
have  watched  in  the  night  (and  no  more).  Day  sleep  is 
the  outcome  of  perverted  nature  and  all  the  Doshas  of 
the  body  are  aggravated  by  a  sleep  in  the  day,  bringing 
on  many  a  troublesome  complaints  such  as  cough, 
asthma,  catarrh,heaviness  of  the  body,  aching  or  lassitude 
in  the  limbs,  fever,  loss  of  appetite  etc.  On  the  other 
hand,  the  keeping  of  late  hours  in  the  night  develops 
symptoms  (Upadrava)  which  are  peculiar  to  the  deranged 
Vayu  and  Pittam.     ^6. 

lYIemorable  Verses  :~Hence,  one  should  not 

sleep  in  the  day, nor  keep  late  hours.  Having  known  both 
these  acts  to  be  injurious,  the  wise  should  observe 
moderation  in  sleep.  A  conformity  to  the  preceding 
rule  of  conduct  is  rewarded  with  health,  good  humour, 
strength,  healthful  complexion,  virility  and  beauty,  a 
frame  which  is  neither  too  fat  nor  too  thin, and  a  long  life 
of  a  hundred  years).  A  day  sleep  may  not  prove  injurious^ 
to  those  who  are  habituated  to  it  and  conversely  keeping 
late  hours  at  night  may  not  tell  upon  the  health  of  those 
to  whom  it  is  customary.     37-39. 

An  aggravated  condition  of  the  bodily  Vayu  or 
Pittam,  an  aggrieved  state  of  the  mind,  loss  of  vital 
fluid,  and  a  hurt  or  an  injury  may  bring  on  insomnia,  the 
remedy  being  the  adoption  of  measures  antagonistic  to 
those  which  destroy  sleep.  The  following  measures  are 
useful  in  cases  of  sleeplessness -such  as  anointing  the 
body,  rubbing  of  oil  on  the  head,  soft  massages  of  the 
body  (with  cleansing  paste)  and  shampooing  ;  a  diet 
consisting  of  cakes  and  pastry  made  up  of  Sali-rice  and 


152  THE  SUSHRUTA   SAMHITA.  Chap.  IV.] 

wheat  prepared  with  sugar  or  other  derivatives  of  sugar- 
cane, sweet  or  soothing  articles  with  milk  or  meat  juice 
or  flesh  of  animals  of  the  Biskira  or  Viles'aya  class, 
and  eating  of  grapes,  sugar  and  sugar-cane  at  night,  are 
beneficial  (^in  such  cases; ;  so  also  a  soft  and  pleasant 
bed,  and  easy  and  convenient  seats  and  means  of  loco- 
motion. Hence,  a  wise  physician  should  advise  those 
and  similar  other  measures  to  allay  insomnia.     40-41. 

Excessive  sleep  should  be  remedied  by  emetics, 
Sansodhana  measures,  fastings,  bleeding,  and  works 
which  tend  to  disturb  the  mental  equanimity  of  man. 
Keeping  up  at  night  is  beneficial  to  persons  afflicted  with 
obesity,  poison  or  the  deranged  Kapham  ;  so  also  a  nap 
in  the  day  is  beneficial  to  people  troubled  with  hiccough, 
colic  pain,  dysentery,  indigestion,  or  thirst.     42-43. 

Somnolence  or  Drowsiness  etc.  :  -in 

this  kind  of  ligHt  sleep,  or  in  th^  preliminary  stage  of 
sleep,  the  sense  organ?  are  overpowered  and  remain 
only  partially  cognisant  of  their  respective  objects  and 
all  (subjective  and  objective)  symptoms  of  a  sleepy 
person  such  as,  yawning,  sense  off  atigue  and  heaviness 
o(  the  limbs,  present  themselves  in  succession  ;  these  are 
the  special  features  of  Tandrai.  One  (prolonged)  inha- 
ling of  the  air  through  a  widely  open  mouth  and 
subsequent  exhaling  with  the  contraction  of  the  limbs 
and  tearful  eyes  are  (all  together)  called  Jrimbha^  or 
yawning. 

A  sense  of  fatigue  without  any  physical  labour  which 
comes  upon  a  person  unaccompanied  by  hurried  res- 
piration is  called  Klama.  It  obstructs  the  proper 
functions  of  the  senses  as  also  the  workings  of  the  active 
organs.*  An  inordinate  love  of  pleasure  and  a  great 
aversion  to  pain,  attended  with  an  apathy  to  all  sorts  of 

*    Hand,  leg,  anus,  and  generative  organ  etc. 


Chap.  IV.]  SARIRA   STHANAM.  1 53 

work  even  with  the  capacity  of  carrying  them  through  is 
called  Alasyam  (laziness).  Nausea,  without  vomiting  of 
invested  food,  attended  with  salivation  and  formation 
of  sputum,  and  cardiac  distress  are  the  symptoms  of 
Utklesham.  A  sweet  taste  in  the  mouth,  drowsiness, 
a  beating  pain  in  the  heart,  dizziness,  and  non-relish 
for  food  are  the  signs  of  Glaiai  (languor).  A  feeling  as 
if  the  whole  body  were  wrapped  in  a  wet  sheet,  accom- 
panied by  an  extreme  heaviness  of  the  heart,  is  called 
Gauravam.    44- 50- 

Loss  of  consciousness  (Murchchai)  is  due  to  an  excess 
of  the  deranged  Pittam  and  to  the  quality  of  the  Tamas  ; 
vertigo  (Bhrama)  is  due  to  an  aggravated  state  of  the 
Vdyu,  Pittam, and  to  the  quality  of  the  Rajas  ;  drowsiness 
(Tandra()  is  due  to  a  similar  condition  of  the  Vdyu, 
Kapham  and  to  the  quality  of  the  Tamas  ;  while  sleep 
(Nidratj  is  produced  by  the  predominance  of  Kapham  and 
to  the  quality  of  the  Tamas  in  the  organism.     51. 

The  growch  of  a  foetus  in  the  womb  is  effected  by 
the  serum  (Rasa)  prepared  out  of  the  food  (assimilated 
by  its  mother)  incarcerated  by  the  Vdyu  in  the  internal 
passage  of  its  body.     52. 

Memorable  Verses  :— Be  it  dearly  under- 
stood that  there  exists  fire  or  heat  (Jyoti)  in  the  umbilical 
region  of  the  foetus  which  is  fanned  by  its  bodily 
Vdyu  and  thus  contributes  to  the  growth  of  its  body. 
The  same  Vayu  in  combination  with  the  heat  (thus 
generated),  expands  the  upward,  downward,  and  lateral 
channels  (in  the  body  of  the  embryo)  and  thus  leads 
to  the  growth  of  the  foetus.  The  eyes  (Dristi—  aper- 
ture of  sight)    and    the    hair-follicles  of  a  man    do    not 

*  lo  the  text  we  find  the  word  "Indriya"  which  refers  to  both 
Jnanendriya  (sensory  functions)  and  Karmendriya  (motor  functions)  of 
the  body. 

20 


I$4  THE  SUSHRUTA  SAMHITA.  [Chap.  IV. 

participate  at  all  (in  the  general  expansion  of  the  body). 
This  is  a  law  of  nature,  and  is  the  opinion  of  Dhanvantari. 
.On  the  other  hand  the  growth  of  hair  and  finger  nails 
continue  even  when  the  body  enters  the  stage  of  decay. 
This  also  is  a  law  of  nature.     SS'S^* 

The  Temperaments  :— The  temperaments 
(Prakriti)  of  persons  may  be  of  seven  different  types, 
according  as  the  deranged  Doshas  of  the  body  are 
involved  therein,  either  severally,  or  in  combination 
of  two  or  of  all  the  three  together.  The  temperament 
(Prakriti)  of  a  man  is  determined  by  the  preponder- 
ance of  the  particular  Doshas  at  the  time  of  his  genera- 
tion (actual  combination  of  the  semen  and  ovum)  and 
is  marked  by  that  preponderant  Dosha.  The  character- 
istics of  the  different  Prakritis  are  now  described.    57-58. 

Vataja-Temperament :— A  man  of  Vdtika- 

temparament  is  wakeful,  averse  to  bathing  and  cold 
contact,  unshapely,  thievish,  vain,  dishonest  and  fond 
of  music  ;  the  soles  of  his  feet,  and  the  palms  of  his 
hands  are  much  fissured  ;  has  often  a  rough  and  grisly 
beard  and  moustache,  finger  nails  and  hairs  in  him  ; 
he  is  hot-tempered  and  is  given  to  biting  his  finger 
nails  and  grinding  his  teeth  (when  asleep).  Morally  he 
is  impulsive,  unsteady  in  his  friendship,  ungrateful,  lean, 
and  rough  ;  his  body  is  marked  with  a  large  number  of 
prominent  veins  (Dhamani) ;  he  is  incoherent  in  his 
habit  and  vacillating  in  his  temper.-  He  is  a  fast  walker 
and  dreams  of  scaling  the  skies  in  his  sleep.  His  eyes 
are  always  moving.  His  mind  is  never  steady.  He 
makes  few  friends,  is  capable  of  accumulating  very 
little  money  and  talks  incoherently.  The  traits  of 
his  characteretc.  seem  to  resemble  those  of  a  goat, 
jackal,  hare,   mouse,  camel,  dog,  vulture,  crow,  and  of  an 

ass.     59-60. 


I 
I 


Chap.   IV.]  SARIRA   STHANAM.  1 55 

Pittvaja-Tcmperamcnt :— A      man     of 

Pittvaja  temperament  perspires  copiously  emitting  a  fetid 
smell.  His  limbs  are  loosely  shaped  and  yellowish  in 
colour.  The  finger  nails,  eyes,  palate,  tongue,  lips,  soles 
and  palms  of  such  a  person  are  copper-coloured.  He  looks 
ugly  with  wrinkles, baldness  and  grey  hair;  he  eats  much, 
is  averse  to  warmth  and  irritable  in  temper,  though  he 
cools  down  very  soon.  He  is  a  man  of  middling  strength 
and  lives  up  to  middle  age.  He  is  intelligent  and 
possesses  a  good  retentive  memory  and  loves  to 
monopolise  the  conversation  (by  pulling  down  any 
speaker  that  may  be  present).  He  is  vigorous  and 
is  simply  irresistible  in  battle.  He  dreams  in  his 
sleep  of  such  things  as  meteors,  lightning-flashes,  fire, 
Ndgeshvara,  Palas'a  or  Karnikara  plants.  He  is  never 
overpowered  with  fear  nor  bends  before  a  powerful 
antagonist ;  he  protects  the  suppliant  and  is  very  often 
afflicted  with  suppuration  in  the  cavity  of  the  mouth. 
The  traits  of  his  character  resemble  those  of  a  serpent, 
an  owl,  a  Gandharba  (heavenly  musician),  Yaksha,  cat, 
monkey^  tiger,  bear,  and  of  a  mongoose.     61-64. 

Kaphaja-Tempcrament :  —The  complexion 

of  a  man  of  5  leshmd  temperament  resembles  either 
the  colour  of  a  blade  of  grass,  blue  lotus,  polished 
sword,  wet  Arishta,  or  that  of  the  stem  of  the  Sara  grass. 
He  is  comely  in  appearance,  fond  of  sweet  tastes, 
grateful,  self-controlled,  forbearing,  unselfish  and  strong  ; 
he  does  not  hastily  form  any  opinion,  and  is  fast  in  his 
enmity.  His  eyes  are  white  ;  his  hair  curly  and  raven 
black.  He  is  prosperous  in  life.  His  voice  resembles  the 
rumblings  of  a  rain-cloud,  the  roar  of  a  lion,  or  the 
sound  of  a  Mridanga.  He  dreams  in  his  sleep  of  large 
lakes  or  pools  decked  with  myriads  of  full  blown  lotus 
flowers,  swans  and    Chakravdkas.     His  eyes  are  slightly 


156  THE  SOSHRUTA   SAMHITA.  [Chap  IV. 

red  towards  the  corners,  the  limbs  are  proportionate  and 
symmetrically  developed  with  a  cool  effulgence  radiating 
from  them  He  is  possessed  of  the  qualities  of  the 
Sittvika  stamp,  capable  of  sustaining  pain  and  fatigue 
and  respectful  towards  his  superiors  He  possesses  faith 
in  the  Sdstras  and  is  unflinching  and  unchanging  in  his 
friendship  ;  he  suffers  no  vicissitudes  of  fortune,  makes 
large  gifts  after  long  deliberation,  is  true  to  his  word 
and  always  obedient  to  his  preceptors.  The  traits  of  his 
character  resemble  those  of  Brahma,  Rudra,  Indra, 
Varuna,  a  lion,  horse,  an  elephant,  cow,  bull,  an  eagle, 
swan  and  of  the  lower  animals.     65-68. 

A  combination  of  two  different  temperaments  should 
be  called  a  double  temperament  or  a  Dvandaja  one  ; 
and  one  of  all  the  three  temperaments  in  a  person 
should  be  stated  as  a  Satnnipaitika  one.     69. 

The  temperament  of  a  man  is  never  altered,  nor 
does  it  suffer  any  deterioration  or  abatement.  A 
change,  abatement  or  deterioration  in  any  particular 
case  should  be  regarded  as  the  harbinger  of  death. 
As  a  worm,  bred  in  poison,  is  not  troubled  with  it, 
so  the  temperament  of  a  person  however  painful  to 
others  does  no  inconvenience  to  himself.  Several 
authorities  hold  that  the  temperaments  of  persons  have 
their  origin  in  the  material  elements  of  the  body  and 
accordingly  they  classify  them  as  the  Va'tika  Prakriti, 
the  Taijasa  Prakriti,  and  the  Apya  (watery)  Prakriti, 
the  characteristic  traits  of  which  respectively  correspond 
to  the  first  three  temperaments  described  above.  70—71. 

A  man  of  the  Pairthiva  temperament  is  large  in 
his  stature, and  is  firm,  strong  and  muscular  in  his  limbs. 
A  man  of  the  Nabhasa  temperament  is  pious  and 
long-lived,  has  large  aural  cavities.  The  mental  tempera- 
ments are  classified  according  to  their  qualities.      72. 


Chap.  IV.]  SARIRA   STHANAM.  1 57 

Sattvika    Features  :— The    features   of   a 

Brahma-kaiya    person  are  cleanliness  of  person  and  con- 
duct, belief  in  the  existence  of  God,  a  constant  reader  of 
the    Vedas,   a    worship    and    reverence   of    elders   and 
preceptors,     hospitality     and    celebration    of     religious 
sacrifices.  Those  of  a  Mahendra-ka^ya  person  are  valour, 
command,    constant   discussion   of  the    Sastras,    main- 
tenance   of   servants  and  dependents  and  magnanimity. 
The  features  of  a  Karnna-ka^ya  person  are  a  liking  for 
exposure  to  cold,  forbearance,  a  brown  hue  of  the  pupils, 
golden    colour   of  the    hair    and    sweet    speech.        The 
features  of    a   Kouvera-kaya    person    are,    arbitration 
of  disputes,    capacity  of  bearing  hardships,  earning    and 
accumulation  of  wealth,    and    capacity  of  propagation 
or  fertility.     The  features  of  a  Gandharva-kaya  person 
are  love    of  garlands   and    perfumes,  fondness  of  songs 
and  music,  and  love  making.    The  features  of  a  Yamya- 
Sattva  person  are    sense    of  duty,  promptness,  firmness 
of    action,     courage,     memory,    purity,    and     absence 
of  anger,  illusion,   fear   and  malice.     The  features  of  a 
Rishi-Sattva    man    are   divine    contemplation,     obser- 
vance of  vows,  complete  sexual  abstinence,  performance 
of  Homas,  celebration  of  religious  sacrifices,  knowledge, 
wisdom  and  cultivation   of  divine   or  spiritual    science. 
These   seven    types   of  men   should    be   considered    as 
belonging   to   the    Sattvika  group   (of  Sdttvika   mental 
temperament).     Now  hear  me   describe  the   features   of 
men  of  Rdjasika  stamp  (of  mind).     73. 

R^ijasika    Features :— Asura-Sattva    men 

are  affluent  in  circumstances,  dreadful,  valorous,  irascible, 
jealous  of  other  men's  excellence,  gluttonous  and  fond 
of  eating  alone  without  sharing  with  any  one  else.  A 
Sarpa-Sattva  man  is  irritable,  laborious,  cowardly, 
angry,  double-dealing,    and  hasty    in    eating   and  sexual 


i$S  THE   SUSHRUTA   SAMHITA.  [Chap.  IV. 

intercourse.  A  ^akuna-Sattva  man  is  gluttonous, 
intemperate  in  sexual  matters,  irritable  and  fickle.  A 
Ratkshasa-Sattva  man  is  solitary  in  his  habits,  fierce, 
jealous  of  others  excellence,  externally  pious,  extremely 
vain  and  ignorant.  The  characteristics  of  a  Paisaclia- 
Sattva  man  are  eating  food  partaken  of  by  another,  irri- 
tability of  temper,  rashness,  shamelessness,  and  covetous- 
ness  of  female  possessions.  Those  of  Preta-Sattva  man 
are  utter  want  of  knowledge  as  regards  duty,  laziness, 
miserableness,  envy,  covetousness,  niggardliness.  These 
six  belong  to  the  Rajasika  cast  of  mind.  Now  hear 
me  describe  the  characteristic  traits  of  men  of  the 
Tamasika  temperaments.     74. 

Tamasika   Features:— The    features   of  a 

Pais'ava-Sattva  man  are  perverseness  of  intellect,  parsi- 
moniousness,  frequent  sexual  dreams  and  incapacity  of 
ascertaining  or  discerning  anything.  The  features  of 
Matsya-Sattva  man  are  unsteadiness,  stupidity,  cowar- 
dice, fond  of  intermissive  quarrel  and  oppression  and  a 
longing  for  water.  The  features  of  a  Vanaspati-Sattva 
man  are  fondness  of  staying  at  the  same  place,  constant 
eating  and  absence  of  truthfulness,  piety,  riches  and 
enjoyment.  Thus  the  three  types  of  Tamasika  tempera- 
ment have  been  described,  A  physician  should  take  in 
hand  a  patient  with  an  eye  towards  these  mental  traits 
etc.  A  physician  should  coolly  deliberate  upon  the 
different  types  of  temperament  described  herein  and 
their  characteristic  features.     7S'7^- 

Thus  ends  the  fourth  Chapter  of  the  S'arira   Sthdnam    in  the  S'uss'ruta 
Samhita  which  treats  of  foetal  development  etc. 


CHAPTER  V. 

Now  we  shall  discourse  on  the  Sariram  which   treats 
of    the    anatomy     of     the     human      body    (SsTrira- 

^ankhya-Vyakaranam).    i. 

Definition  of  Garbha  and  ^arira  ;— 

The  combined  semen  and  ovum  (Sukra  and  Sonita)  in 
the  womb,  mixed  with  (the  eight  categories  known  as) 
the  Prakriti  and  (her  sixteen  modifications  known  as) 
Vikdra,  and  ridden  in  by  the  Atmat  (self-consicous  self^, 
is  called  the  foetus.  There  is  consciousness  in  the 
embryo.  The  Vatyu  (or  the  vital  force)  divides  it  into 
Dosha,  Dhdtu,  Mala,  etc.,  limbs,  and  organs,  etc.  The 
Teja  (or  the  heat  latent  in  the  fecundated  matter)  gives 
rise  to  the  metabolism  of  the  tissues  ;  the  Apa  (water) 
keeps  it  in  a  liquid  state  ;  the  Kshiti  (earth)  is  embodied 
in  the  shape  of  its  species  ;  and  the  Akas'a  (ether)  contri- 
butes to  its  growth  and  development.  A  fully  developed 
foetus  with  all  its  parts,  such  as  the  hands,  feet,  tongue, 
nose,  ears,  buttocks  etc.  and  the  sense-organs,  is  called 
Satriram  or  body.  The  body  is  composed  of  six 
main  parts,  namely,  the  four  extremities  (upper  and 
lower),  the  trunk  or  middle  body,  and  the  head.     2. 

Different  members  of  the  body  :— Now 

we  shall  describe  the  Pratyangas  or  members  of  the 
body.  The  head,  the  belly  (Epigastrium),  the  back,  the 
navel  (umbilical  region),  the  forehead,  the  nose,  the  chin, 
the  bladder,  and  the  throat  (neck),  occur  singly  ;  the 
ears,  the  eyes,  the  nostrils,  the  eye-brows,  the  temples, 
the  shoulders,  the  cheek,  the  armpits,  the  breasts,  the 
testes,  the  sides,  the  buttocks,  the  arms,  the  thighs,  and 
the   knee-joints,   etc.,   occur    in   pairs.     The  fingers  and 


l6o  THE  SUSHRUTA  SAMHITA  .  [Chap,  V. 

toes  which  number  twenty  in  all,  and  the  interior 
channels  (Srotas)  of  the  body,  to  be  presently  described, 
are  likewise  included  within  the  Pratyangas.  These 
are  the  different  Pratyang'as  or  members.     3. 

Enumeration  Of  the  different  limbs 
and   members  of  the  body  :— The  different 

layers  of  the  skin,  the  Kalas,  the  Dhatus  (root  principles, 
such  as  blood,  chyle,  etc.),  the  Mala  (excrements  ,  the 
Doshas  (morbific  principles,  such  as  the  Vayu,  Pittam, 
or  Kapham\  the  spleen,  the  liver,  the  lungs,  the  colon 
and  caecum  (Unduka),  the  heart,  the  cavities  or  viscera 
(Asayas),  the  intestines  (Antras),  the  Vrikkou  (Kidneys) 
the  Srotas  (internal  passages  or  ducts),  the  Kandara 
(nerve  trunks),  the  Jalas  (membranes),  the  Kurchas,*  the 
Rajjus  (tendons)  the  Sevanis  (sutures),  the  Sanghdtas 
(facets),  the  Simanta,  the  bones,  the  joints,  the  Snd,yu 
(ligament),  the  Pes'i  (muscles),  the  Marmas  (vital  parts, 
such  as  anastomosis  of  veins  and  arteries,  etc.),  the  Sira 
(veins),  the  Dhamani  (arteries),  and  the  Yogavahini 
Sr5tasf,  constitute  what  is  collectively  called  the 
organism.     4. 

Their  number  :— The  layers  fof  skin  (Tvaka) 
number  seven  in  all.  There  are  seven  connective  tissues 
or  fascia  (Kalds).  The  cavities  or  viscera  (Asayas)  are 
seven  in  all.  The  root  principles  (Dhatu)  of  the  body 
are  seven  in  number.  There  are  seven  hundred  S'ird 
(veins),  five  hundred  Pes'i  (muscles),  nine  hundred 
Snayu  (ligaments),  three  hundred  bones,  two  hundred 
and  ten  Sandhi  ^joints),  one  hundred  and  seven  Marmas 
(vital  parts),  twenty-four  Dhamanis  (arteries  etc.),  three 
Doshas  (morbific  principle— such  as    the  V^yu,    Pittam, 

*  Meetings  of  muscles,  ligament?,  veins,  nerves  and   bones    as    at   the 
annular  ligament. 

t  Those,  that  are  in  connection  with  the  Dhamani. 


Chap,  v.]  SARIRA   STHANAM,  i6g^ 

to  the  Sushira  type.  The  ligaments  of  the  chest,  back, 
sides  and  head  are  of  the  Prithu  type.     34—35. 

As  a  boat  made  of  planks  and  timber  fastened 
together  by  means  of  a  large  number  of  bindings 
is  enabled  to  float  on  the  water  and  to  carry  cargo  ;• 
so  the  human  frame  being  bound  and  fastened  at  the 
Sandhis  or  joints  by  a  large  number  of  ligaments. 
(Snayu)  is  enabled  to  bear  pr:^ssure.  An  injury  to,,  or 
diseases  of,  the  bones,  veins,  joints  or  muscles  are  not  so 
detrimental  to  the  system  as  is  the  case  if  the  Snayus 
are  affected  in  any  way.  Only  the  physician,  who  is 
acquainted  with  the  internal  and  external  ligaments 
(Sndyus)  of  the  body,  is  qualified  to  extract  a  hidden 
and  imbedded  Salyam  (extraneous  matter  etc.)  from  any 
part  of  the  body.     36. 

The  lYIuSCleS  (PcsiS)  :— The  muscles  (Pesis) 
number  five  hundred  in  all,  of  which  four  hundred 
are  in  the  four  extremities  ;  Sixty-six*  in.  the 
trunk  (Koshtha)  and  thirty-four  in  the  region  above  the 
clavicles.     37. 

IVIuscIes  in  the  Extremities  :— There  are 

three  muscles  in  each  of  the  toes,  thus  making  .fifteen 
in  the  toes  of  one  leg  ;  ten  in  the  anterior  part  of  the  foot 
and  the  same  number  (ten")  attached  to  the  Kurchcha  ; 
ten  in  the  sole  and  the  ankle-bone  (Gulpha, — malledi)  ; 
twenty  in  the  region  between  the  Gulpha  and  the  knee- 
joint ;  five  in  the  knee-joint  (Janu)  ;  twenty  in  the  thigh 
(Uru)  ;  and  ten  in  the  groin  (Vankshana) ;  thus  making 
one  hundred  muscles  in  all  in  each  leg.  The  same 
number  is  found  in  each  of  the  other  three  extremities  ; 
(thus  making  four  hundred  in  all).     2^. 

Muscles  in  the  Koshtha  :  -(Of  the  sixty- 
six   muscles  in  the  trunk),  three  are  in  the  region  of  the 

*  Gayadasa  reads  sixty  in  the  trunks  and  forty  above  the  clavicles, 

22 


170  THE  SUSHRUTA  SAMHITA.  Chap.  V.] 

anus  (Pa/u) ;  one  In  the  penis;  one  in  the  perineum 
(Sevan i) ;  two  in  the  scrotum  ;  five  in  each  of  the 
haunches  (Sphik)  ;  two  in  the  top  or  head  of  the 
bladder ;  five  in  the  abdomen  (Udara)  ;  one  about  the 
umbilicus  ;  five  along  each  side  (of  the  spinal  column), 
on  the  upper  part  of  the  back  (making  ten  in  all)  ;  six 
in  the  sides  ;  ten  in  the  chest  ;  seven  around  the  armpits 
and  shoulders  (Akshaka-Ansa)  ;  two  in  the  region  of 
heart  and  stomach  (Amas'aya)  ;  and  six  in  the  region 
of  the  liver,  spleen  and  colon  (Unduka).     39. 

IVIuscIesof  the  Head  and  Neck  :— (Of 

the  thirty-four  muscles  found  in  this  region),  four  are  in 
the  throat  (Grivd)  ;  eight  in  the  two  jaw-bones  (Hanu)  ; 
one  each  in  the  regions  of  the  throat  (Kakalaka  and 
Gala)  ;  two  in  the  palate  ;  one  in  the  tongue  ;  two  in 
the  lips  :  two  in  the  nose  ;  two  in  the  eyes  ;  four  in  the 
cheeks  ;  two  in  the  ears  ;  four  in  the  forehead  ;  and 
one  in  the  head.  Thus  the  positions  and  distribu- 
tions of  the  five  hundred  muscles  (Pesis)  have  been 
described.    40. 

Metrical  Text  :~The  ligaments,  veins,  bones 
and  joints  etc.,  of  a  human  body,  derive  their  strength 
from  the  fact  of  their  being  supported  by  or  covered  over 
by  the  muscles.     41. 

Extra    IVIuscIes    in    Women  :— Females 

have  twenty  extra  muscles  ;  ten  muscles  are  to  be  found 
about  the  two  breasts,  five  in  each,  which  (muscles) 
attain  their  full  growth  during  puberty  ;  four  muscles 
are  present  about  the  parturient  passage  ;  and  of  these 
(four)  two  are  about  the  external  and  two  in  the  internal 
orifices  (of  the  vagina) ;  three  about  the  region  of  the 
OS,  and  three  along  the  passages  of  the  ovum  and  sperm. 
The  Garbhasaya  or  uterus  is  situated  in  the  space 
bounded  by  the  Pittas'aya  (small  intestine)  and  Pakv^s'aya 


Cliap.  V.j  SARIRA  STHANAM.  I^I 

(large  intestine)   and   the  foetus  lies   in    this   during   the 
period  of  gestation.*     42-43. 

According  to  their  position  in  the  system,  these 
muscles  are  found  to  be  thick,  slender,  small,  expanded, 
circular,  short,  long,  hard,  soft,  smooth  or  rough.  The 
muscles  cover  the  veins,  ligaments,  bones  and  joints; 
hence  their  shape  and  size  are  determined  by  the 
exigencies  (organic  structures)  of  their  positions.     44. 

Memorable   Verses  :  -The   muscles  which 

are  found  in  the  penis  and  scrotum  of  a  man  as  des- 
cribed before  correspond  to  the  covering  of  the  uterus 
in  the  case  of  a  woman  owing  to  the  absence  of  those 
organs  in  her  body.  The  positions  and  classifications 
of  the  veins,  channels,  Marmas  and  arteries  will  be 
dealt  with  in  a  separate  chapter.     45-46. 

The  vagina  of  a  woman  resembles  the  navel  of  a 
conch-shell  in  shape  and  is  possessed  of  three  involuted 
turns  (Avartas)  like  the  interior  of  mollusc.  The  uterus 
(Garbhas'aya — foetal  bed)  is  situated  at  the  third  posterior 
involuted  turn.  The  shape  of  the  uterus  resembles  the 
mouth  of  a  Rohit-fish  (narrow  at  the  mouth  and  expanded 
in  the  upper  end).  The  foetus  lies  in  a  crouched  or 
doubled  up  posture  in  the  uterus  and  thus  naturally  at 
the  time  of  parturition  its  head  is  presented  at  the 
entrance  to  the  vagina.     47-48. 

Superiority  of  ^alya-Tantram  :-The 

different  parts  or  members  of  the  body  as  mentioned 
before  including  even  the  skin  cannot  be  correctly 
described  by  any  one  who  is  not  versed  in  Anatomy. 
Hence,  any  one  desirous  of  acquiring  a  thorough 
knowledge  of  anatomy  should  prepare  a  dead  body 
and  carefully   observe   (by   dissecting  it)  and  examine 

*  If  we  read  Mutras.'aya  (bladder)  in    place   of    Piltda'aya   it   explains 
the  anatomy  better.— Ed, 


-iJ2  THE  StJSHRUTA  SAMHITA.  Chap.  V.] 

its  different  parts.  For  a  thorough  knowledge  can  only 
be  acquired  by  comparing  the  accounts  given  in  the 
SAstras'  (books  on  the  subject)  by  direct  personal 
observation.     49. 

IVlode  of  dissection  :— A  dead  body  selected 
for  this  purpose  should  not  be  wanting  in  any  of  its  parts, 
should  not  be  a  person  who  had  lived  up  to  a  hundred 
years  (i.  e.  too  old  age)  or  ol  one  who  died  from  any 
protracted  disease  or  of  poison.  The  excrementa  should 
be  first  removed  from  the  entrails  and  the  body  should 
be  left  to  decompose  in  the  water  of  a  solitary  and  still 
pool,  and  securely  placed  in  a  cage  (so  that  it  may  not  be 
eaten  away  by  fish  nor  drift  away),  after  having  covered 
it  entirely  with  the  outer  sheaths  of  Munja  grass,  Ktis'a 
grass, hemp  or  with  rope  etc.  After  seven  days  the  body 
would  be  thoroughly  decomposed,  when  the  observer 
should  slowly  scrape  off' the  decomposed  skin  etc.  with  a 
whisk  made  of  grass-roots,  hair,  Kusa  blade  or  with  a 
strip  of  split  bamboo  and  carefully  observe  with  his  own 
eyes  all  the  various  different  organs,  external  and  internal, 
beginning  with  the  skin  as  described  before,     50  —  56. 

IVlemorabIc  Verses  :— The  Self,  the  occult 

or  invisible  Lord  of  the  body  cannot  be  detected  except 
with  the  psychic  eye  or  with  that  of  the  mind.  He,  who 
has  observed  the  internal  mechanism  of  the  human  body 
and  is  well  read  in  the  works  bearing  on  these  subjects 
and  has  thus  all  his  doubts  expelled  from  his  mind  is 
alone  qualified  in  the  science  of  Ayurveda  and  has  a 
rightful  claim  to  practise  the  art  of  healing.     57. 

Thus   ends   the    fifth   Chapter    of  the    S'arira-sthanam  in  the  Sus'rula 
Samhitii  w  hich  treats  of  the  anatomy  of  the  human  body. 


CHAPTER  VI. 

Now  vvc  shall  discourse  on  the  Sdrlram  which   speci- 
fically treats  of  the  Mannas*  or  vital  parts  of   the    body 

(Pratyeka-marma-nirdcsa  Sariram.)  i. 
Classification   of  IVI  arm  as  :— There  are 

one  hundred  and  seven  Marmas  (^in  the  human  organ- 
ism), which  may  be  divided  into  five  classes,  such  as 
the  Mcinsa-Marmas,  Sira-Marmas,  Sndyu-Marmas,  Asthi- 
Marmas  and  the  Sandhi-Marmas.  Indeed  there  are  no 
other  Marmas  (vulnerable  or  vital  parts)  to  be  fuund 
in  the  body  than  the  preceding  ones.     2. 

Their   different    numbers  :— There  are 

eleven  Mansa-Marmas  (vulnerable  muscle-joints)  ;  forty- 
one  Sird-Marmas  (similar  veins,  anastomosis)  ;  twenty- 
seven  Snayu-Marmas  (vital  ligament-unions)  ;  eight 
Asthi-Marmas  (bone-unions)  and  twenty  Sandhi-Marmas 
(^vulnerable  joints).     3. 

Their  Locations  :~0f  these,  eleven  are  in 
one  leg,  thus  making  twenty-two  in  the  two  lower  ex- 
tremities, The  same  number  counts  in  the  two  hands. 
There  are  twelve  Marmas  in  the  regions  of  the 
chest  and  the  abdomen  (Udara) ;  fourteen  in  the  back  ; 
and  thirty-seven  in  the  region  of  the  neck  (Griva)  and 
above  it.     4. 

Names  and  distributions  of  IVIarmas : 

— The  Marmas  which  are  situated  in  each  leg  are  known 
as  Kshipra,  Tala-Hridaya,  Kurchcha,  Kurchcha-Sirah, 
Gulpha,  Indravasti,  Janu,  Ani,  Urvi,  Lohitaksha  and 
Vitapa.     The  twelve  Marmas  which  are  situated  in    the 

Places  where  veins,  arteries,  ligaments,   joints   and    mu.cles   unite 
and  an  injury  to  which  proves  j^encrally  fatal. 


i 


i;?'4  THE  SUSHRUTA  SAMHItA.  Chap.  Vl.] 

thorax  and  the  abdomen  (Udara)  are  Guda  (anus),  Vast! 
(bladdery,  xN^abhi  (umbilicus),  Hridaya  (heart),  Stana- 
mula  (the  roots  of  two  breasts),  the  Stana-Rohita, 
(muscles  of  the  breasts\  the  two  Apalaps  and  the  two 
Apastambhas.  The  fourteen  Marmas  to  be  found  in 
the  back  are  the  Katika-tarunas  (Taruna-bones  of  the 
waist',  the  two  Kukundaras,  the  two  Nitamvas  (hips), 
Pars  va-Sandhis  (the  two  side-joints),  the  two  Vrihatis, 
the  two  Ansa-phalnkas  (shoulder-blades)  and  the  two 
Ansas  (shoulders).  The  eleven  Marmas  to  be  found  in  an 
arm  are  known  as  the  Kshipra,  Tala-Hridaya,  Kurchcha, 
Kurchcha-Sirah,  Manivandha,  Indravasti,  Kurpara, 
Ani,  Urvi,  Lohitaksha  and  Kakshadhara.  What  is  said  of 
the  one  arm  holds  good  of  the  other.  The  Marmas  situated 
above  the  clavicle  regions  are  known  as  the  four  Dhamanis, 
the  eight  Matrikas,the  twoKrikatikas,  the  two  Vidhuras, 
the  two  Phanas,  the  two  Apangas,  the  two  Avartas,  the 
two  Utkshepas,  the  two  Sankhas,  one  Sthapani  five 
Simantas,  four  Sringatakas  and  one  Adhipati.     5—9. 

The  different  heads  of   IVIarmas:— Of 

the  aforesaid  Marmas,  those  known  as  the  Tala- 
Hridaya,  Indravasti,  Guda  and  Stana-rohita,  are 
Mayas  a- Marmas.  Those  known  as  Nila-dhamani, 
Matrika,  Sringataka,  Apanga,  Sthapani,  Phana,  Stana- 
mula,  Apalapa,  Apastambha,  Hridaya,  Nabhi,  Pars'va- 
Sandhi,  Vrihati,  Lohitaksha  and  Urvi,  are  Sirat-Marmas. 
Those  known  as  the  Ani,  Vitapa,  Kakshadhara, 
Kurchcha,  Kurchcha-Sirah,  Vasti,  Kshipra,  Ansas, 
(shoulders),  Vidhura  and  Utkshepa,  are  Snaiyu-Marmas. 
Those  known  as  the  Katika-taruna,  Nitamva,  Ansa- 
phalaka,  Sankha,  are  Asthi-Marmas.  The  Janu,  the 
Kurpara,  the  Simanta,  the  Adhipati,  the  Gulpha,  the 
Manivandha,  the  Kukundara,  the  Avarta  and  the 
Krikatika  arc  Saudhi-Marmas.     10—14. 


Chap.  VI.]  SARIRA   ST  HAN  AM.  1/5 

Qualitative  classes  :— Again  these  Marmas 
(vital  unions  of  the  body)  are  under  five  distinct  heads, 
namely,  Sadya-Pranahara,  (fatal  within  twenty-four 
hours),  Kalantara-Pranahara,  (fatal  within  a  fortnight 
or  a  month),  Visalyaghna  (fatal  as  soon  as  a  dart  or  any 
other  imbedded  foreign  matter  is  extracted  therefrom), 
Vaikalyakara,  (maiming  or  deforming)  and  Rujakar 
(painful)  [according  as  an  injury  respectively  produces 
the  aforesaid  effects].  Of  these,  nineteen  Marmas 
belong  to  the  Sadya-Prdnahara  group  ;  thirty-three  to 
the  Kalantara-Pranahara  group  ;  three  to  the  Visalya- 
ghna group;  forty-four  to  the  Vaikalyakara  group  ;  and 
eight  to  the  Rujcikara  group.      15. 

Memorable  Verses  :— To  the  Sadya-Praina- 

hara  group  (fatal  in  the  course  of  a  day  if  anywa\'  hurt) 
belong  the  four  Sring^takas,  one  Adhipati,  the  two 
Sankhas,  the  eight  Kantha-Sirds,  the  Guda,  the 
Hridaya,  the  Vasti  and  the  Nabhi.  To  the  Kailadltara- 
Pranahara  group  (fatal  later  on,  if  any  way  hurt) 
belong  the  eight  Vaksha-Marmas,  the  five  Simantas, 
the  four  Tala-Marmas,  the  four  Kshipra-Marmas,  the 
four  Indra-vastis,  the  two  Katika-tarunas,  the  two 
Parsva-Sandhis,  the  two  Vrihatis,  and  the  two 
Nitamvas.  To  the  Visalyaghna  class  belong  the  two 
Utkshepas  and  the  one  Sthapani.  To  the  Vaikalyakara 
(deforming)  group  belong  the  Marmas,  known  as  the 
four  Lohitakshas,  the  four  An  is,  the  two  Jdnus,  the 
four  Urvis,  the  four  Kurchchas,  the  two  Vitapas,  the 
two  Kurparas,  the  two  Kukundaras,  the  two  Kaksha- 
dharas,  the  two  Vidhuras,  the  two  Krikatikas,  the  two 
Ansas  (shoulder),  the  two  Ansa-phalaka.s,  (shoulder- 
blades),  the  two  Apangas  (tips  of  eyes),  the  two  Nials, 
the  two  Manyas,  the  two  Phanas  and  the  two  Avartas. 
A  learned  physician  should  know  that  the  two  Gulphas, 


176  THE   SUSHRUTA   SAMIIITA.  [Chap.  VI. 

the  two  Mani-vandhas  and  the  four  Kurchcha-S'irah  (of 
the  hands  and  legs)  belong  to  the  Rujakara  group 
(painful  if  hurt).  A  piercing  of  the  Kshipra-Marma 
ends  in  an  instantaneous  death  ;  or  death  may  follow 
at  a  later  time.     16-2  t. 

Firm  unions  of  Mdnsa  (muscles),  Sira  (veins),  Snayu 
(ligaments),  bones  or  bone-joints  are  called  Marmas 
(or  vital  parts  of  the  body)  which  naturally  and  specifi- 
cally form  the  seats  of  life  (Pratna),  and  hence  a  hurt  to 
any  one  of  the  Marmas  invariably  produces  such  symp- 
toms as  arise  from  the  hurt  of  a  certain  Marma.*     22. 

The  Marmas  belonging  to  the  Sadya-Pranahara  group 
are  possessed  of  fiery  virtues  (thermogenetic)  ;  as 
fiery  virtues  are  easily  enfeebled,  so  they  prove  fatal 
to  life  (in  the  event  of  being  any  way  hurt)  ;  while 
those  belonging  to  the  Kalantara-Pranahara  group  are 
fiery  and  lunar  (cool)  in  their  properties.  And 
as  the  fiery  virtues  are  enfeebled  easily  and  the  cooling 
virtues  take  a  considerable  time  in  being  so,  the 
Marmas  of  this  group  prove  fatal  in  the  long  run  (in 
the  event  of  being  any  way  hurt,  if  not  instantaneously 
like  the  preceding  ones).  The  Vis'alyaghna  Marmas 
are  possessed  of  Vataja  properties  (that  is,  they  arrest 
the  escape  of  the  vital  Vayu)  ;  so  long  as  the  dart 
does  not  allow  the  Vayu  to  escape  from  their  injured 
interior,  the  life  prolongs  ;  but  as  soon  as  the  dart  is 
extricated,  the  Vayu  escapes  from  the  inside  of  the 
hurt  and  necessarily  proves  fatal.  The  Vaikalyakaras 
are  possessed  of  Saumya  (lunar  properties)  and  they 
retain  the  vital  fluid  owing  to  their  steady  and  cooling 
virtues,  and  hence  tend    only   to   deform    the   organism 

*  Some  are  of  opinion  that  hallucination,  delirium,  death,  stupor  and 
coma  as  described  in  the  Sutrast  anam  are  the  results  of  injuries  to 
thes    Mar    as. 


Chap.  VI.]  SARIRA  STHANAM.  IJJ 

in  the  event  of  their  being  hurt,  instead  of  bringing 
on  death.  The  Ruj^kara  Marmas  of  fiery  and  Vataja 
properties  become  extremely  painful  inasmuch  as  both 
of  them  are  pain-generating  in  their  properties. 
Others,  on  the  contrary,  hold  the  pain  to  be  the  result 
of  the  properties  of  the  five  material  components  of 
the  body  (Pancha-bhautika).     23. 

Different  Opinions  on  the  IVIarmas :  — 

Some  assert  that  Marmas,  which  are  the  firm  union  of 
the  five  bodily  factors  (of  veins,  ligaments,  muscles,  bones 
and  joints),  belong  to  the  first  group  (Sadya-Prana- 
hara) ;  that  those,  which  form  the  junction  of  four  such,  or 
in  which  there  is  one  in  smaller  quantity,  will  prove  fatal 
in  the  long  run,  in  the  event  of  their  being  hurt  or  injured 
(Kdldntara-Pranahara).*  Those,  which  are  the  junction 
of  three  such  factors,  belong  to  the  Vis'alya-Prcinahara-f* 
group  ;    those   of  the  two  belong  to  the  Vaikalyakara  X 

*  The  Marmas,  such  as  Stana-mula,  Apalapa,  Apastambha, 
Simanta,  Katika-Taruna,  Parsva-Sandhi,  Vrihati,  and  Nitamva  be- 
longing to  the  Kalantara-maraka  group,  are  devoid  of  Mansa  (muscles)  ; 
and  the  'Marmas'  known  as  Stanarohita,  Talahridaya,  Kshipra,  and 
Indravasti,  belonging  to  the  same  class,  are  devoid  of  Asthi  (honest 

t  The  Ulkshepa  marma,  belonging  to  the  Vis'alya.pr^nahara 
group,  is  devoid  of  Mansa  (muscles)  and  Sandhi  (joint). 

X  The  Sthapani- Marma,  belonging  to  the  Vaikalyakara  class,  is 
devoid  of  Mansa  (muscle),  S'ira  and  Snayu  ;  (he  Lohitaksha-marma 
(of  the  same  group)  is  devoid  of  Snayu,  Sandhi  and  Asthi  (bones)  ;  the 
Janu-marma  (of  the  same  group)  is  devoid  of  Mansa,  S'ira  and  Snayu: 
the  Urvi-marma  (of  the  said  group)  is  devoid  of  Asthi,  Mansa  and  Snayu  ; 
the  Vitapa-marma  (of  the  same  class)  is  devoid  of  Mansa,  Sira  and  Asthi ; 
the  Kurpara-marma  (of  the  same  class)  is  devoid  of  Mansa,  S'ira, 
and  Snayu  ;  the  Kukundara-marma  (of  the  same  class)  is  devoid 
of  Mansa,  S'ira  and  Sandhi  ;  the  Kakshadhara-marma  (of  the  same 
class)  is  devoid  of  S'ira,  Asthi,  and  Sandhi  ;  the  Vidhura-marma  (of  the 
said  group)  is  devoid  of  Mansa,  Sira  and  Sandhi  ;  the  Krikatika-marma 
is  devoid  of  Mansa,  S'ira,  and  Sandhi;  the  Ansa-marma  (of  the  same 
group)  is  devoid  of  Mansa,  Snayu  and  Sandhi  ;  the  Ansa-phalaka-marma 

2\ 


178  THE  SUSHRUTA  SAMHITA .  [Chap.  VI. 

group  ;  and  those  in  which  only  one  of  them  exists 
belongs  to  the  last  or  pain-generating  type  (Rujdkara)*. 

But  the  fore  going  theory  is  not  a  sound  one,  inas- 
much as  blood  is  found  to  exude  from  an  injured  joint 
which  would  be  an  impossibility  in  the  absence  of  any 
vein,  ligament  (Snayu)  and  muscle  being  intimately 
connected  with  it.  Hence  every  Marma  should  be 
understood  as  a  junction  or  meeting  place  of  the  five 
organic  principles  of  ligaments,  veins,  muscles,  bones 
and  joints.     24-25. 

IVletrical  text:— This  is  further  corroborated 
by  the  fact  that  the  four  classes  of  Sira  or  vessels  (which 
respectively  carry  the  Vdyu,  Pitta,  Kapha  and  the  blood) 
are  found  to  enter  into  the  Marmas  for  the  purpose 
of  keeping  or  maintaining  the  moisture  of  the  local 
ligaments  (Snayu),  bones,  muscles  and  joints  and  thus 
sustain  the  organism.f  The  Vayu,  aggravated  by  an 
injury  to  a  Marma,  blocks  up  (those  four  classes  of 
vessels)  in  their  entire  course  throughout  the  organism 
and  gives  rise  to  great  pain  which  extends  all  over  the 
body.  All  the  internal  mechanism  of  a  man  (of  which  a 
Marma  has  been  pierced  into  with  a  shaft  or  with  any 
other  piercing  matter)  becomes  extremely  painful,  and 
seems  as  if  it  were  being  constantly  shaken  or  jerked, 
and  symptoms  of  syncope  are  found  to  set  in.  Hence  a 
careful   examination    of    the    affected    Marma     should 

(of  the  said  group)  is  devoid  of  Mansa,  Snayu  and  Sandhi  ;  the  Nila, 
Manya  and  Phana  Marmas  (of  the  same  group)  are  devoid  of  Mansa, 
Sandhi  and  Asthi ;  the  Avarta-marma  is  devoid  of  S'irsL,  Sniyu  and 
Mansa  ;  the  Apdnga. marma  (of  the  said  class)  is  devoid  of  Mansa,  Sniyu 
and  Sandhi. 

*  The  Gulpha,  Manibandha,  and  Kurchcha-s'ira  Marmas,  belonging 
to  the  Rujakara  group,  are  devoid  of  Mansa,  S'ir^,  Sniyu  and  Asthi,  i.e. 
Sandhi  alone  is  present  in  these. 

t  Hence  the  piercing  of  a  bone  is  attended  with  bleeding. 


Chap.  VI.]  SARIRA   STHANAM,  179 

precede  all  the  foregoing  acts  of  extricating  a  Salya  from 
its  inside.  From  that  similar  aggravated  conditions  and 
actions  of  the  Pitta  and  the  Kapha  should  be  presumed 
in  the  event  of  a  Marma  being  any  v^ay  injured  or 
pierced  into.     26—29. 

A  Marma  of  the  Sadyah-Pr^nahara  type  being 
perforated  at  its  edge  brings  on  death  at  a  later  time 
(within  seven  days),  whereas  a  deformity  of  the  organ 
follows  from  the  piercing  of  a  Kdlantara-Miraka* 
Marma  at  the  side  (instead  of  in  the  centre).  Similarly, 
an  excruciating  pain  and  distressful  after-effects  mark  a 
similar  perforation  of  a  Marma  of  the  Vis'alyaghnaf 
group.  And  a  Marma  of  the  Rujdkara|:  class  pro- 
duces an  excruciating  pain  (instead  of  a  sharp  one)  in 
the  event  of  its  being  pierced  at  the  fringe.     30. 

An  injured  Marma  of  the  Sadyah-Pranahara  type 
terminates  in  death  within  seven  days  of  the  injury, 
while  one  of  the  Kaldntara  type,  within  a  fortnight  or  a 
month  from  the  date  of  hurt  (according  to  circumstances). 
A  case  of  injured  Kshipra-Marma  seldom  proves  fatal 
before  that  time  (seven  days).  An  injured  Marma  of  the 
Vis'alyaghna  or  Vaikalyakara  group  may  prove  fatal 
in  the  event  of  its  being  severely  injured.     31. 

Marmas  of  the  Extremities  :— Now  we 

shall    describe   the   situation    of   every    Marma.       The 

*  If  any  of  the  Marmas  of  the  Kalanlara-Pranahara  group  be 
deeply  perforated,  then  this  perforation  is  sure  to  bring  on  death  within 
a  day  {i.e.  it  will  act  like  a  slightly  injured  Marma  of  the  Sadyah- 
Pranahara  group). 

t  Any  M.-irma  of  the  Vis'aiyaghna-group,  being  deeply  perforated, 
brings  on  death  within  seven  days  (/.  e.  it  will  behave  like  a  slightly 
injured  Marma  of  the  Kalantara-Prknahara  class). 

t  Any  Marma  of  the.  Rujakara  class,  being  deeply  perforated  (injured), 
is  sure  to  bring  excruciating  pain  etc,  (i.e.,  it  will  act  like  a  slightly 
injured  Marma    of  the  Vis'alyaghna  group). 


rSo  THE  SUSHRUTA  SAMHITA.  [Chap.    VI. 

Marma,  known  as  the  Kshipra*,  is  situated  in  the 
region  between  the  first  and  the  second  toes  (Tarsal 
articulation),  which,  being  injured  or  pierced,  brings 
on  death  from  convulsions.  The  Marma,  known  as  the 
Tala-Hridayat,  is  situated  in  the  middle  of  the  sole 
of  the  foot  in  a  straight  line  drawn  from  the  root  of 
the  middle  toe.  An  injury  to  this  Marma  gives  rise  to 
extreme  pain  which  ends  in  death.  The  Marma,  known 
as  the  Kurchchat,  is  situated  two  fingers'  width 
above  from  the  Kshipra  one  on  each  side  of  the 
foot.  An  injury  to  this  Marma  results  in  shivering 
and  bending  in  of  the  foot.  The  Marma  called 
Kurchcha-Sirah  §  is  situated  under  the  ankle-joints, 
one  on  each  side  of  the  foot  (Gulpha-Sandhi)  ;  an 
injury  to  it  gives  rise  to  pain  and  swelling  of  the 
affected  part.  A  perforation  of  the  Gulpha-Marma  !!, 
which  is  situated  at  the  junction  of  the  foot  and 
the  calf,  results  in  pain,  paralysis  and  maimedness 
of  the  affected  leg.     32-37- 

An  injury  to  the  Marma  which  is.  situated  in  the 
middle  muscle  of  the  calf  to  the  distance  of  between 
twelve  and  thirteen  fingers'  width  from  the  ankle,  and 
known  as  the  Indravasti-Marma^lT  results  in  excessive 
haemorrhage  which  ends  in  death.     38. 

*  It  is  a  Snayu-Marma  (ligament)  to   the  width    of  half  a   finger,    and 
belongs  to  the  Kalantara  group. 

t  It  is  a  Mansa-Marma  to  the  width  of  half  a  finger  and  belongs  to  the 
Kalantara  group. 

:;  It  is  a  Snayu-Marma  to  the  length  of  four  fingers'  width,  and 
belongs  to  the  Vaikalyakara  group. 

§  It  is  a  Snayu-Marma,  one  finger  in  length  and  belongs  to  the 
Vaikalyakara  group. 

II  It  is  a  Sandhi-Marma,  to  the  length  of  two  fingers',  and  belongs  to 
the  Vaikalyakara  group. 

IF     Indravasti  measures  two  fingers  in  length  according  to   Bhoja  and 


Chap.  VI.]  SARIRA   ST  HAN  AM.  iSl 

An  injury  to  or  piercing  of  the  Jatnu-Marma* 
situated  at  the  union  of  the  thigh  and  the  knee,  results 
in  lameness  of  the  patient.     39. 

A  piercing  of  the  Aui-Marma,+  situated  on  both  the 
sides  above  three  fingers'  width  from  the  Jdnu  (knee  joint), 
brings  on  swelling  and  paralysis  (numbness)  of  the 
leg.     40. 

A  perforation  of  the  Urvi-Marma,t  situated  in  the 
middle  of  the  Uru  (thigh),  results  in  the  atrophy 
of  the  leg,  owing  to  the  incidental  haemorrhage.  An 
injury  to  the  Lohitaiksha-Marma,ll  situated  respectively 
a  little  above  and  below  the  Urvi-Marma  and  the 
Vankshana  (groin-joint),  and  placed  near  the  thigh,  is 
attended  with  excessive  haemorrhage  and  causes  para- 
lysis (of  the  leg).     41-42. 

An  injury  to  the  Vitapa-Marma,^  situated  between 
the  Scrotum  and  the  Vankshana  (inguinal  region),  brings 
on  loss  of  manhood  or  scantiness  of  semen.  Thus  the 
eleven  Sakthi-Marmas  of  one  leg  have  been  described  ; 
those  in  the  other  being  of  an  identical  nature  with  the 
preceding  ones.  The  Marmas  in  the  hands  are  almost 
identical  with  those  of  the  legs,  with  the  exception  that 
Manivandha,    Kurpara  and     Kakshadhara    Marmas 

Gayadasa,  though  half  a  finger  in  width  according  to  others.  It  is  a 
Mansa-Marma  and  belongs  to  the  Kalantara  group. 

*  It  is  a  joint-Marma,  three  fingers  in  length  and  belongs  to  the 
Vaikalyakara  group. 

t  It  is  a  ligam';nt-Marma,  half  a  finger  in  length,  (three  fingers 
according  to  Gayadasa)  and  is  of  the  Vaikalyakara  class. 

X  It  is  a  S'ira-Marma,  half  a  finger  in  length  and  of  the  Vaikalya- 
kara group, 

II  It  is  a  S'ira-Marma,  halfa  finger  in  length  and  of  the  Vaikalya. 
kara  group. 

IT  It  is  a  Snayu-Marma  to  the  length  of  one  finger  and  of  the 
Vaikalyakara  group. 


l82  THE  SUSHRUTA   SAMHITA.  [Chap.  VI. 

occur  in  the  place  of  the  Gulpha,  Jdnu  and 
Vitapa  Marmas  respectively.  As  the  Vitapa-Marma 
is  situated  between  the  scrotum  and  the  Vankshana 
(inguinal  region),  so  the  Kakshadhara-Marma  is  situated 
between  the  Vaksha  (chest)  and  the  Kaksha  (armpit). 
An  injury  to  these  causes  supervening  symptoms. 
An  injury  to  the  Manivandha-Marma  (wrist-marma) 
results  specially  in  inoperativeness  (Kuntha)  of  the 
affected  hand  ;  an  injury  to  the  Kurpara-Marma  ends 
in  dangling  (Kuni)  of  the  hand  ;  and  an  injury  to 
the  Kakshadhara  results  in  hemiplegia.  Thus  the 
forty-four  Marmas  of  the  upper  and  the  lower  extremi- 
ties have  been  described.     43-46. 

Marmas  on  the  Thorax  etc.  :— Now  we 

shall  describe  the  Marmas,  situated  in  the  region  of 
the  thorax  and  the  abdomen  (trunk).  A  hurt  to 
the  Guda-Marma*,  which  is  attached  to  the  large 
intestine  and  serves  as  the  passage  of  stool  and  flatus, 
ends  fatally  (within  twenty-four  hours  of  the  hurt). 
An  injury  to  the  Vasti-Marma,t  situated  inside 
the  cavity  of  the  pelvic  region  and  the  bladder  and 
composed  of  small  muscles  and  blood  (and  which 
serves  as  the  receptacle  of  urine),  proves  fatal  with- 
in the  day,  except  in  the  cases  of  extracting  the 
gravel,  only  when  the  injury  to  the  organ  is  short 
of  complete  perforation  of  both  of  its  walls.  The 
urine  oozes  out  through  the  aperture  in  the  case 
where  only  one  of  its  walls  has  been  perforated,  and 
which  may  be  closed  and  healed  up  with  proper 
and  judicious    medical   treatment.     An    injury   to   the 

*  It  is  a  Mansa-Marma  to  the  length  of  four  fingers'  width  and  be. 
long?  to  the  Sadyo-maraka  class. 

+  It  is  a  ligament  combination  (Snayumarma)  to  the  length  of  four 
fingers,  belonging  to  the  Sadyah-Pranhara  class. 


Chap.  VI.i  SARIRA   STHANAM.  183 

Natbhi-Marma,*  the  root  of  all  the  Siras  and  situated 
between  the  Amdsaya  (stomach)  and  the  Pakv^s'aya 
(intestines)  ends  in  death  within  the  day.     47-50. 

A  hurt  to  the  Hridaya-Marma,t  which  is  situated 
in  the  thorax  between  the  two  breasts  and  above  the 
pit  of  the  Amasaya  and  forms  the  seat  of  the  qualities 
of  Sattva,  Rajas  and  Tamas,  proves  fatal  within  the 
day.  An  injury  to  the  Stana-mula-Marmas,]:  situated 
immediately  below  each  of  the  breasts  and  about  two 
fingers  in  width  fills  the  Koshtha  (thorax)  with  deranged 
Kapha,  brings  on  cough,  difficult  breathing  (asthma) 
and  proves  fatal.  An  injury  to  any  of  the  Stana- 
Rohita-Marinas,§  situated  above  the  nipples  of 
the  breasts  about  two  fingers  in  width,  fills  the  cavity 
of  the  Koshtha  (thorax)  with  blood,  producing  symptoms 
of  cough  and  asthma,  and  ends  fatally.  An  injury  to 
the  Apalaipa-Marmas,!!  situated  below  the  Ansa-kuta 
(balls  of  the  shoulders)  and  above  the  sides  (meeting 
of  the  different  branches  of  the  sub-clavicle  veins  ue. 
axilla',  transforms  the  blood  of  the  organism  into  pus 
and  proves  fatal  thereby.     51-54. 

An  injury  to  any  of  the  Vayu-carrying  vessels,  known 
as  the  Apastambha-Marmalf  (meeting  of  the  bifurcated 
branches    of    the     bronchi     lying     on    both   the   sides 

*  It  is  a  S'ira-Marma  to  the  length  of  four  fingers,  belonging  to  the 
Sadyah-Pranahara  class. 

t  It  is  a  S'ira-Marma  to  the  length  of  four  fingers  and  of  the  Sadyah- 
Pranahara  class. 

+  It  is  a  S'ira-Marma,  two  fingers  in  length  and  of  the  Kalantara 
class. 

§  It  is  a  Mansa-Marma  about  half  a  finger  in  length  and  of  the 
Kalantara  class,  (according  to  Vgabhata,    of  the  Sadyo-Maraka  class). 

II  It  is  a  S'ir^.Marma,  half  a  finger  in  length,  and  of  the  Kalantara 
class. 

H  It  is  a  S'ira-Marma,  half  a  finger  in  length  and  belongs  to  the 
Kalantara  class. 


1 84  THE  SUSHRUTA  SAMHITA.  [Chap.  Vl. 

of  the  breast),  fills  the  Koshtha  with  the  deranged 
Vayu  (tympanites)  accomapanied  by  cough  and  dys- 
pepsia, and  terminates  in  death.  Thus  the  twelve 
Marmas  situated  in  the  thorax  and  abdomen  are 
described.     55-56. 

PriShtha  Marmas  :— Now  we  shall  discourse 
on  the  Marmas  in  the  back  (of  a  man).  An  injury  to 
any  of  the  Katika-tarunas*  (sacro-iliac  articulation), 
situated  in  the  region  of  the  S'roni  Csacrum)  on  both 
sides  of  the  spinal  column,  gives  rise  to  an  excessive 
haemorrhage  and  consequent  pallor  and  ends  in  death. 
A  hurt  to  any  of  the  Kukundara  Marmas  |  (lit  : — a 
hollow — the  great  sacro-sciatic  notch),  situated  on  both 
sides  of  the  spinal  column  and  in  the  region  slightly 
below  the  waist  (in  the  loins),  results  in  complete 
anaesthesia  and  inoperativeness  of  the  lower  extremi- 
ties. A  hurt  to  the  Nitamva-Marmas,|  attached  to 
the  side  above  the  Sroni  (pelvis)  and  attached  inside  to 
the  muscles  of  the  waists,  gives  rise  to  Sosha  (atrophia) 
in  the  lower  extremities,  weakness  and  ultimately  brings 
on  death.  An  injury  to  the  PairsVa-Sandhi-Marmas  § 
(caelic  axes)  which  are  situated  just  at  the  middle  below 
the  extremities  of  the  sides  (P^rsva)  and  which  lies 
attached  at  the  middle  between  the  loins  at  their  lower 
regions,  feels  the  Koshtha  (abdomen)  with  the  blood 
and  results  into  death    A  hurt  to  the  Vrihati-Marmas  1] 

*  It  is  an  Aslhi-Marma,  half  a  finger  in  length  and  of  the  Kalantara- 
maraka  class. 

t  They  ate  Joint-matmas  (Sandhi),  half  a  finger  in  length  and  of  the 
Vaikalyakara  group. 

J  It  is  a  bone  Marma,  half  a  finger  in  length,  and  of  the  Kalantara  clas§, 

§  It  is  a  S'ira-Marma  to  the  length  of  half  a  finger  and  belongs  to 
the  Kalantara  class. 

li  They  are  S'ira-Marmas  (arterial  anestomsis)  to  the  lengt  of  half 
a  finger  and  belong  to  the  KaUntara  class. 


Chap.  VI.J  SARIRA  STHANAM.  iS$ 

which  commencing  from  the  roots  of  the  breast 
course  round  both  the  sides  of  the  spinal  column 
(Pristha-vams'a),  cause  excessive  bleeding,  and  the  patient 
dies,  as  supervening  symptoms  arise  from  an  excessive 
loss  of  blood.  An  injury  to  any  of  the  two  Amsa-phalaka» 
Marmas*  situated  on  either  side  of  the  vertebral  column 
and  connected  with  the  scapula  brings  on  anesthesia 
or  atrophy  (Sopha)  of  the  arms.  There  are  two  Marmas 
known  as  Amsa-Marmasf  which  are  situated  on  either 
side  midway  between  the  neck  and  the  head  of  the  arms 
and  connect  the  Amsa-Pitha  (glenoid  cavity)  and  the 
Skandha  (shoulder).  An  injury  to  any  of  these  Marmas 
is  attended  with  an  incapacity  of  moving  the  hands. 
Thus  the  fourteen  Marmas  in  the  back  have  been 
described.  57-65. 

The  Jatrugata- Marmas  :-Now  we  shall 

describe  the  Marmas  which  are  situated  in  the  regions 
above  the  clavicles  (Urddhva-Jatru).  There  are  four 
Dhamani  (arteries)  about  the  two  sides  of  the  Kantha- 
Nadi  (wind-pipe).  Two  of  them  are  known  as  Nilai,  and 
the  other  two  as  Manyai.  One  Nild  and  one  Manyd  are 
situated  on  either  side  of  the  larynx,  (i.e  ,  anterior  and 
posterior  side  of  the  larynxl  An  injury  to  any  of  them 
produces  dumbness,  and  change  of  voice  (hoarseness), 
and  also  the  loss  of  the  faculty  of  taste.  |  An  injury  to 
any  of  the  eight  Siras  (arteries),  four  being  on  each  side 
of  the  neck  (Griva),  and  known  as  Sirak-Ma^trika- 
Marmas  §  )  ends  fatally  within  the  day.     65-69. 

*     It  is  an  Asthi-Marma,  half  a  finger  in  length  and  is  Vaikalyakara. 

t     They   are    Snayu  Marmas,     half   a    finger    in    length   and    of    the 
Vaikalyakara  class. 

t     They  are  S'ira-Marmas,  to  the  lengrh  of    four    fingers    and    of   the 
Vaikalyakara  class. 

§     They  are  S'ira-Marmas,  four  fingers  in  length    and    of    the    Sadyo- 
Matan  class, 

24 


1 86  THE  SUSHRUTA  SAMHttA.  [Chap.  Vl. 

An  injury  to  any  of  the  two  Marmas  lying  at  the 
junction  of  the  head  and  neck  (Griva)  and  known  as 
Krikaitikat*  (transverse  process  of  the  arch  of  the  atlas) 
results  in  a  free  movement  of  the  head.  A  hurt  to  any 
of  the  Marmas  attached  to  the  lower  end  of  an  ear 
(posterior  extrensic  ligament)  and  known  as  the 
Vidhurat  Marma  results  in  the  loss  of  hearing.  An 
injury  to  the  Phana-Marmast  attached  to  the  interior 
channels  of  both  the  nostrils,  results  in  the  loss  of  the 
faculty  of  smell.  An  injury  to  the  Apaknga-Marmas  § 
(Anastomosis  of  the  infra-orbital  artery)  situated  below 
the  tips  of  the  eye-brows  and  about  the  external  corners 
of  the  eyes,  brings  on  blindness  or  defective  vision.  An 
injury  to  the  Avarta-Marmas  11  situated  above  and  below 
the  eye-brows,  brings  on  blindness  and  impaired  vision. 
An  injury  to  the  Sankha-MarmasIT  (meeting  or  suture 
of  the  temporal,  frontal  and  sphenoid  bones — Pterion)^ 
situated  over  the  tips  of  the  eye-brows  and  between  the 
ears  and  the  forehead,  results  in  death  within  the  day. 
The  Marmas  situated  over  the  two  temples  (Sankha) 
and  at  the  border  of  the  hair  (sculp)  are  called  Utkshepa- 
Marma  (meeting  of  the  posterior  and  anterior  temporal 
arteries)$.     An  extraction  of  a  shaft  (Salya)  or   of  any 

*  They  are  Sandhi-Marmas,  half  a  finger  in  length,  and  of  the 
Vaikalyakara  group. 

t     It  is  a  S'nayu-Marma,  and  is  of  the  Vaikalyakara  class. 

%  They  are  S'ira-Marmas  to  the  length  of  half  a  finger  and  of  the 
Vaikalyakara  class, 

§  They  are  S'ira  Marmas  to  the  length  of  half  a  finger  and  of  the 
Vaikalyakara  class. 

II  They  are  Sandhi-Marmas,  to  the  length  of  half  a  finger  and  of  the 
Vaikalyakara  class. 

^    They  are  Asthi-Marmas  to  the  length  of  half  a  finger. 

$  They  are  S'ndyu-Marmas,  half  a  finger  in  length  and  of  the 
Vis'alyaghna  class. 


Chap.  V/. J  SARIRA  STHANAM.  liy 

extraneous  pointed  thing  lodged  into  these  Marmas, 
results  in  the  death  of  the  patient,  who,  on  the  contrary, 
lives  as  long  as  the  shaft  is  allowed  to  remain  inside  or 
if  the  shaft  comes  out  itself  (after  putrefaction).  70-75. 
An  injury  to  the  Sthapani-Marma*  (nasal  arch  of 
the  frontal  veins),  situated  in  the  middle  of  the  eye- 
browSj  ends  in  the  manner  of  the  preceding  one.  An 
injury  Co  any  of  the  five  joints  of  the  head  which  are 
known  as  the  Simanta-Marmast,  results  in  fear,  insensi- 
bility and  madness  of  the  patient  and  terminates  in 
death.  An  injury  to  any  of  the  four  Sringaktaka- 
Marmas]:  which  forms  the  junction  of  the  four  Siras 
(nerves),  (branches  of  the  facial  artery)  and  soothes  the 
nose,  the  eyes,  the  ears  and  the  tongue,  proves  fatal 
within  the  day.  An  injury  to  the  A dhipati- Marmas  § 
(the  vertical  groove  on  the  frontal  bone)  which  is  marked 
in  the  inner  side  of  the  roof  of  the  cranium  by  the  Sifd- 
Sannipdta  (superior  longitudinal  sinus),  and  on  the 
exterior  side  by  the  ringlet  of  the  hair  (Romavarta) 
proves  fatal  within  the  day.  Thus  we  have  described 
the  thirty-seven  Marmas,  situated  in  the  region  aboVe 
the  clavicles  (Urddhva-Jatru).     76-80. 

IVIeinorable  Verses  :— An  incision    should 

be  made  at  the  spot  a  fingers  width  remote  from  the 
Urvi,  Kurchcha-Sir^,  Vitapa,  Kaksha  and  a  Pdrsva- 
Marma  ;    whereas,   a   clear  space  of  two  fingers  should 

*  They  are  S'ira-Marmas  to  the  length    of   half   a    finger   and  of  the 
Visalyaghna  class. 

t  They  are  Sandhi-Marmas  to  the  length  of   four    fingers   and   of  the 
Kalantara-Pranahara  class. 

t  They  are   S'ira-Marmas   to  the    length   of   four    fingers   and  of  the 
Sadyah-Pranahara  class. 

§  It  is  a  Sandhi-Marma,  half  a  finger   in   length   and  of  the   Sadyah- 
Pranahara  class. 


1 88  THE  SUSHRUTA  SAMHITA  .  [Chap.  VI. 

be  avoided  from  its  situation  in  making  any  incision 
about  the  Stanamula,  Manivandha  or  Gulpha-Marma. 
Similarly  a  space  of  three  fingers  should  be  avoided 
from  the  Hridaya,  Vasti,  Kurchcha,  Guda  or  Nabhi 
Marma  ;  and  a  space  of  four  fingers  should  be  avoided 
in  respect  of  the  four  Sringatakas,  five  Simantas  and 
ten  Marmas  in  the  neck  (Nila  etc.)  ;  a  space  of  half 
a  finger  being  the  rule  in  respect  of  the  remaining  (fifty- 
six).*  Men,  versed  in  the  science  of  surgery,  have  laid 
down  the  rule  that,  in  a  case  of  surgical  operation,  the 
situation  and  dimension  of  each  local  Marma  should 
be  first  taken  into  account  and  the  incision  should  be 
made  in  a  way  so  as  not  to  affect  that  particular  Marma, 
inasmuch  as  an  incision,  even  extending  or  affecting, 
in  the  least,  the  edge  or  the  side  of  the  Marma,  may 
prove  fatal.  Hence  all  the  Marma-Sthanas  should  be 
carefully  avoided  in  a  surgical  operation.     8i. 

The  amputation  of  a  hand  or  a  leg  may  not  prove 
fatal  whereas  a  wound  in  any  of  the  Marmas  situated 
therein  is  sure  to  bring  on  death.  The  vessels  become 
contracted  in  the  case  of  a  cut  in  the  leg  or  in  the  hand 
of  a  man,  and  hence  the  incidental  bleeding  is  compara- 
tively scantier.  Therefore  it  is  that  a  cut  in  any  of  these 
parts  of  the  body,  however  painful,  does  not  necessarily 
prove  fatal,  like  the  lopping  off  of  the  branches  of  a 
tree.  On  the  contrary,  a  man  pierced  into  in  any  such 
Marmas,  as  the  Kshipra  or  the  Tala,  suffers  from  excessive 

*  Some  are  of  opinion  that  a  surgical  operation  (in  the  case  of  the 
remaining  fifty-six)  should  be  made,  leaving  a  space  equal  in  measurement 
to  the  dimensions  of  a  palm  (from  the  affected  part).  Gayadasa,  having 
learnt  from  Bhoja,  explains  that  a  space  of  two  fingers  should  be  left  (from 
the  affected  part)  in  making  surgical  operations  of  the  ten  marmas,  namely, 
the  two  Gulphas,  the  roots  of  the  two  breasts,  the  four  Indravastis,  and  the 
two  Manivandhas. 


Chap.  VI.]  SARIRA  STHANAM.  1 89 

hemorrhage  (from  the  affected  part)  and  attended  with 
an  excruciating  pain,  owing  to  the  derangement  of  the 
Vdyu,  and  meets  his  doom  like  a  tree  whose  roots 
have  been  severed.  Hence,  in  a  case  of  piercing  or 
of  injury  to  any  of  these  Marmas,  the  hand  or  the  leg 
should  be  immediately  amputated  at  the  wrist  or  at 
the  ankle  (respectively).     82. 

The  medical  authorities  have  described  the  Marmas 
to  have  covered  half  in  the  scope  of  Salya  Tantra 
(Surgery),  inasmuch  as  a  person  hurt  in  any  of  the 
Marmas  dies  presently  (i.  e.,  within  seven  days  of  the 
hurt).  A  deformity  of  the  organ  is  sure  to  result  from 
an  injury  to  one  of  these  Marmas,  even  if  death  be 
averted  by  a  course  of  judicious  and  skillful  medical 
treatment.     83. 

The  life  of  the  patient  is  not  to  be  despaired  of  even 
in  the  case  of  fracture  or  crushing  of  a  bone  of  the 
Koshtha,  Sirah  and  Kapdla  or  perforation  of  the  intestines 
etc  ,  if  the  local  Marmas  are  found  not  to  be  in  any  way 
hurt  or  affected.  Recovery  is  common  in  cases  of 
cuts  (pierce)  in  the  Sakthi,  Bhuja,  Pdda  and  Kara 
or  in  any  other  part  of  the  body  and  even  where  a 
whole  leg  or  hand  is  found  to  be  severed  and  carried 
away  if  the  Marmas  are  not  in  any  way  hurt  or 
affected.     84. 

These  Marmas  form  the  primary  seats  of  the  Vayu, 
the  Soma  (lunar)  and  Tejas  (fiery  principles  of  the 
organism),  as  well  as  of  the  three  fundamental  qualities 
of  Satva,  Rajas  and  Tamas,  and  that  is  the  reason  why 
a  man,  hurt  in  any  of  the  Marmas,  does  not  live.     85. 

An  injury  to  a  Marmaof  the  Sadyah-Prdnahara  class 
(in  which  death  occurs  within  a  day)  is  attended  with 
the  imperfection  of  the  sense  organs,  loss  of  conscious- 
ness,    bewilderment     of    Manah    (mind)     and    Buddhi 


IQO  THE  SUSHRUTA   SAMHITA.  [Chap  VI. 

(intellect)  and  .various  kinds  of  pain.  An  injury  to  a 
Marma  of  the  KAlantara  group  (of  a  person)  is  sure  to 
be  attended  with  the  loss  of  Dbatus  (blood  etc.)  and 
various  kinds  of  supervening  symptoms  (Upadrava)  which 
end  in  death.  The  body  of  a  person,  hurt  in  any  of 
the  Vaikalyakara  Marmas,  may  remain  operative  only 
under  a  skillful  medical  treatment  ;  but  a  deformity 
of  the  affected  organ  is  inevitable.  An  injury  to  any 
of  the  Vis'alyaghna  Marmas  ends  in  death  for  the 
reasons  mentioned  above.  An  injury  to  any  of  the 
Rujdkara  Marmas  gives  rise  to  various  kinds  of  pain 
in  the  affected  organ,  which  may  ultimately  bring  about 
a  deformity  of  the  same,  if  placed  under  the  treatment 
of  an  ignorant  and  unskillful  Vaidya  (Surgeon).     S6. 

An  injury  to  the  adjacent  part  of  a  Marma,  whether 
incidental  to  a  cut,  incision,  blow  (Abhighdta),  burn, 
puncture,  or  to  any  other  cause  exhibits  the  same 
series  of  symptoms  as  an  actually  affected  one.  An 
injury  to  a  Marma,  whether  it  be  severe  or  slight,  is 
sure  to  bring  deformity  or  death.*    Sy. 

The  diseases  which  are  seated  in  the  Marmas,  are 
generally  serious,  but  they  may  be  made  to  prove 
amenable  with  the  greatest  care  and  difficulty.     88-89. 

*    Gayadasa  does  not  read  this  verse. 

Thus  ends  the  sixth  Chapter  of  the  S'arira   Sthanam   in   the   Sus'ruta 
Samhita,  which  treats  of  Marmas. 


CHAPTER  VII. 

Now   we  shall  discourse  on  the  Siriram  which  treats 
of  the  description  and  classification  of  Sira  or  vascular 

system  *  ( ^irsL-Varnana-Vibhaktinama 
^ariram). 

There  are  seven  hundred  Sirds  (vessels)  in  the 
human  organism  (except  those  which  cannot  be  counted 
for  their  extremely  attenuated  size).  The  vessels 
(Siras)  by  their  contractibility  and  expansibility  &c , 
sustain  and  nourish  the  organism  in  the  same  manner 
as  streamlets  and  canals  serve  to  keep  a  field  or  a 
garden  moist  and  fruitful.  From  the  principal  or  cen- 
tral trunk  hundreds  of  small  and  minute  vessels  branch 
off  and  spread  all  over  the  body,  just  as  small  or  minute 
fibres  are  found  to  emanate  from  the  large  central  vein 
of  the  leaf  of  a  plant.  They  originate  from  the  umbili- 
cal region  and  thence  they  spread  all  over  the  body  up- 
wards and  downwards  and  obliquely.     2. 

IVIemorable  Verses  :— All  the  Siras  (vessels) 

that  are  found  in  the  organisms  of  created  beings,  ori- 
ginate from  the  umbilical  region  (Nabhi)-)*  and  thence 
they  spread  all  over  their  bodies.  The  life  of  an  or- 
ganic animal  is  seated  in  the  vessels  surrounding  its 
navel  which  forms  their  starting  point.  The  navel  in 
its  turn  rests  on  or  is  attached  to  the  Pranas  (the  life- 
carrying  vessels — nerves    attached   to   it)   in   the   same 

*  The  Sanskrita  term  S'ira  denotes  veins,  nerves,  arteries  and  lympha- 
tic  vessels  as  well.  Some  read  S'ird-  Varna  (different  colours  of  the 
Siras)  in  lieu  of  S'ira-varnana  (description  of  S'iras). 

t  Most  probably  the  idea  is  derive!  from  the  appearance  of  the  S'iras 
in  their  foetal  state. 


192  THE   SUSHRUTA  SAMHITA.  tChap.  Vll. 

manner  as  the  nave  of  a  wheel  supports  the  spokes,  and 
the  spokes  in  their  turn  support  the  nave.     3-4. 

Principal  ^iraS:-Of  these  Siras  (vessels), 
forty  are  principal  ones,  of  which  ten  are  Vayu-carrying 
Siras  (nerves),  ten  are  Pitta-carrying  Siras  (veins),  ten 
convey  Kapha  (lymphatic  vessels?)  and  ten  are  blood- 
carrying  Siras  (arteries).  Of  these  the  Vayu-carrying 
Siras,  situated  in  the  specific  receptacle  of  that  bodily 
principle  (Vata),  are  again  found  to  branch  out  in  one 
hundred  and  seventy  five  smaller  branches  (ramifications). 
Similarly,  each  of  the  remaining  Pitta-carrying,  Kapha- 
carrying  and  blood-carrying  vessels  (Sirds)  situated  in 
their  specific  receptacles,  {ie ,  in  the  receptacles  of  Pitta, 
Kapha  and  spleen  and  liver  respectively)  are  found  to 
branch  out  in  as  many  numbers  (one  hundred  and 
seventy-five), — thus  making  a  total  of  seven  hundred 
in  all.     5. 

Their   Specific    Locations :- There   are 

twenty-five  Vayu-carrying  Siras  (nerves)  in  one  leg  and 
the  same  count  applies  to  the  other.  Similarly  there 
are  twenty  five  Vatyu-carrying  Siras  (vessels)  in  each  of 
the  hands.  There  are  thirty-four  Vayu-carrying  vc^ssels 
in  the  Koshtha  trunk) ;  of  these  eight  occur  in  the  pelvic 
regions  attached  with  the  anus  and  the  penis  ;  two  in 
each  of  the  sides,  six  in  the  back,  six  in  the  Udara 
(cavity  of  the  abdomen),  and  ten  in  the  region  of  the 
chest.  There  are  forty-one  Vayu-carrying  Sira's  (ves- 
sels) situated  in  the  region  above  the  clavicles.  Of 
these  fourteen  occur  in  the  neck  ;  four  in  the  two  ears  ; 
nine  in  the  tongue  ;  six  in  the  nose  and  eight  in  the 
two  eyes.  Thus  we  have  finished  the  description  of  the 
one  hundred  and  seventy-five  Siras  that  carry  Vayu.  6. 
What  has  been  said  of  these  Vayu-carrying  vessels 
(Siras)  will  also  hold  good  to  the  rest  (in  blood-carrying, 


Chap.  VII.]  SARIRA  STHANAM.  193 

Pitta-carrying  and  Kapha-carrying  channels  in  the  res- 
pective regions  of  the  body),  with  the  exception  that 
in  these  three  cases,  (  Pitta,  Kapha  and  blood  )  ten 
occur  in  the  eyes  and  two  in  the  ears  in  lieu  of  eight 
and  four  respectively,  as  in  the  case  of  VAyu-carrying 
Siris  (vessels).  Thus  we  have  described  the  seven  hun- 
dred Sirds  with  their  branches.     7. 

Memorable     Verses— The    Vdyu-carrying 

Sirds  :  —The  Vdyu  in  its  normal  state  and  coursing 
through  its  specific  Siras  (vessels)  helps  the  unobstructed 
performance  of  its  specific  functions  viz.^  expansion, 
contraction,  speech,  &c.,  and  produces  the  clearness  and 
non-illusivencss  of  Buddhi  (  intellect  )  and  the  sense- 
organs,  whereas  a  coursing  of  the  said  Vayu  in  a  de- 
ranged condition  through  the  aforesaid  Sirds  (vessels), 
gives  rise  to  a  host  of  such  diseases  as  are  due  to  the 
derangement  of  Vdyu.     8. 

The  Pitta-carrying  ^iras:— The  Pitta  in 

its  normal  state  and  coursing  through  its  specific  S'iras 
(vessels)  produces  the  healthy  glow  of  complexion, 
relish  for  food,  kindling  of  the  appetite,  healthfulnoss 
and  other  good  effects,  characteristic  of  the  Pitta,  which 
however  being  aggravated  and  coursing  through  them 
gives  rise  to  a  host  of  Pittaja  diseases.     9. 

The     Kapha-conveying    firsts:— The 

Kapha  in  its  normal  state  and  coursing  through  its  specific 
Sirds  (vessels)  smoothes  and  contributes  to  the  firmne33 
of  the  limb3  and  joints,  improves  the  strength  and  pro- 
duces all  other  good  effects  specially  belonging  to  it, 
whereas  the  same  Kapha,  flowing  through  them  in  an 
aggravated  condition,  ushers  in  a  large  number  of  the 
Kaphaja  distempers  of  the  body.     10. 

The  Rakta-carryi  ng  ^i  rsis  : —The  blood 

in  its  normal  state  and  flowing  through  its  specific  S'irds 

25 


t94  THE  SUSHRUTA  SAMHITA.  [Chap.  VII. 

(vessels)  strengthens  the  other  fundamental  principles 
(Dhatus)  of  the  body,  improves  the  complexion,  aids 
the  organ  of  touch  in  the  proper  performance  of  its 
functions  and  produces  other  functions  characteristic  of 
it  in  the  body.  Flowing  through  them  in  a  vitiated 
condition,  it  begets  diseases  which  are  due  to  the  de- 
rangement of  the  blood,      ii. 

There  is  not  a  single  Sira  (vessel)  in  the  body 
which  carries  either  the  Vayu,  or  the  Pitta  or  the 
Kapha  alone.  Hence  each  of  the  vessels  should  be 
regarded  as  affording  an  opportunity  for  conveying  all 
kinds  of  the  Doshas  of  the  body,  for  as  soon  as  they  are 
deranged  and  aggravated  they  seem  to  flow  through  all 
the  Sirds  promiscuously.  Hence  they  are  called  Sarva- 
vahah.    12. 

Specific  colours   of  the  ^iras:-The 

vessels  which  carry  the  bodily  Vayu  (nerves)  have  a 
vermilion  (yellowish  red)  hue  and  seem  to  be  stuffed 
with  Vdyu.  The  Pitta-carrying  vessels  (veins)  are 
coloured  blue  and  felt  warm  to  the  touch.  The  Kapha- 
carrying  vessels  are  hard,  cold  to  the  touch  and  white- 
coloured.  The  blood-carrying  vessels  (arteries)  are  red 
and  neither  too  hot,  nor  too  cold.     13. 

Now  we  shall  describe  the  Siras  (veins)  which  a 
surgeon  should  not  pierce  or  open,  inasmuch  as  it  may 
result  in  death,  or  bodily  deformity.  An  intelligent 
surgeon  shall  always  bear  in  mind  that  sixteen  out  of 
the  four  hundred  vessels  in  the  extremeties,  thirty-two 
out  of  the  hundred  and  thirty-six  vessels  in  the  trunk 
and  fifty  out  of  the  sixty-four  vessels  in  the  region  above 
the  clavicles,  should  not  be  opened  or  bled  on  any 
account.     14-15- 

Of  the  one  hundred  vessels  in  a  single  leg,  the  one 
Jdla<ihard   (which   is   attached    to  the  connective  tissue 


Chap,  vn.]  SARIRA   STHANAM.  ,lg5 

of  the  Kurchcha-Sirah)  as  well  as  the  three  internal 
ones,  of  which  two  are  known  as  the  Urvi- veins  and  the 
other  as  the  Lohitiksha,  together  with  the  correspond- 
ing ones  in  the  other  leg  and  in  the  two  hands,  thus 
making  sixteen  in  all,  which  are  situated  in  the  upper 
and  lower  extremeties,  should  be  held  unfit  for  opening. 
Of  the  thirty-two  veins  in  the  pelvic  region  (Sroni),  eight 
such,  known  as  the  four)Vitapas  (two  on  each  side  of  the 
testicles)  and  the  four  known  as  the  Katika-tarun  as  (two 
on  each  side)  should  be  considered  unfit  for  bleeding  or 
opening.  Of  the  sixteen  veins  (eight  on  each  side)  at  the 
sides,  the  one  which  courses  upward  from  each  of  the  two 
sides  and  is  attached  to  the  Marma  known  as  the  Patrs'va- 
Sandhi,  should  be  considered  unfit  for  similar  purposes. 
Of  the  twenty-four  Siras  which  are  found  in  either  side 
of  the  spinal  column,  an  incision  should  not  be  made 
into  any  of  the  two  Siras  (on  each  side)  known  as 
the  Vrihati  and  which  run  upward  along  either  side 
of  it  (spinal  column).  Similarly  of  the  twenty-four  Siras 
in  the  abdomen,  the  two  along  each  of  the  two  sides  of 
symphis  pubis  should  be  held  unfit  for  opening  or 
bleeding.  Of  the  forty  veins  in  the  chest,  the  two  in  the 
heart,  two  in  the  root  of  each  breast  and  two  in  each 
of  the  Stana-rohita  (muscle  of  the  breast)  and  one  in 
each  of  the  Apastambhas  and  Apalapas,  making  fourteen 
in  all,  should  not  be  opened.  Thus  thirty-two  Siras  in 
the  regions  of  the  back  (i.  e.,  the  sides  and  the  pelvic 
regions),  the  abdomen  and  the  chest  should  be  regarded 
as  unfit  for  opening  or  other  surgical  purposes.  16—21. 
There  are  one  hundred  and  sixty-four  Sirds  in  the 
region  above  the  clavicles.  Of  these  the  eight  and  four 
(making  twelve  and  respectively  known  as  the  eight 
Matrikas,  the  two  Nilas  and  the  two  Manyas)  out 
of  the  fifty-six  in  the  neck  and    the    throat,    should  .  be 


196  THE   SUSHRUTA   SAMHITA.  tChap.  Vll. 

regarded  as  unfit  for  opening.  Similarly  the  two  veins 
in  the  two  Krik^tikds  and  two  in  the  two  Vidhuras, 
should  be  held  unfit  for  similar  purposes ;  thus  making 
sixteen  in  all  in  the  neck.  Of  the  sixteen  vessels  (eight 
on  each  side)  of  the  Hanus  (Jaws),  the  two  Siras  about 
each  of  the  joint  of  the  jaw-bones  should  never  be 
opened.     22. 

Of  the  thirty-six*  vessels  in  the  tongue,  sixteen  are 
situated  in  the  under-surface  of  that  organ  and  twenty 
in  the  upper  surface  ;  of  these  the  two  speech-carrying 
and  the  two  taste-carrying  ones  should  be  held  unfit  for 
venesection.  Of  the  twenty-four  vessels  in  the  nose, 
the  four  adjacent  to  the  nose  proper  and  the  one  running 
into  the  soft  palate  should  be  held  unfit  for  similar 
purposes.  Of  the  thirty-eight  vessels  in  the  two  eyes, 
the  one  situated  at  each  Apanga  should  not  be 
opened.  Of  the  ten  vessels  in  the  two  ears,  the  sound- 
carrying  one  in  either  ear  should  not  be  opened.  Of 
the  sixty  vessels  of  the  nose  and  eyes  coursing 
through  the  region  of  the  forehead,  the  four  vessels 
adjacent  to  the  sculp  proper  and  the  Avarta-Marma 
should  be  held  unfit  for  opening  or  bleeding.  One 
vessel  (Sird)  in  each  of  the  two  Avartas  and  the  one  in 
the  Sthapani-marma  should  not  be  opened  (on  any 
account).  Of  the  ten  vessels  in  the  temple,  the  one 
about  each  temple-joint  should  be  held  unfit  for  opening 
or   bleeding.     Of  the  twelve  vessels  in  the  head,  the  one 

*Gayi  asserts  that  there  are  eight  each  of  the  Vayu-carrying,  Pitta- 
Carrying,  Kapha-carrying  and  blood-carrying  S'iras  in  the  region  of  the 
neck,  thus  making  a  total  of  32  in  place  of  36  of  the  text. 

He  also  holds  that  there  are  28  in  place  of  36  S'irds  in  the  tongue, 
16  in  place  of  24  in  the  nose,  24  in  place  of  38  in  the  eyes,  16  in  place  of 
10  in  the  ears  and  8  in  place  of  10  in  the  temple.  In  the  counting  of  the 
S'iras  situate  in  the  other  parts  of  the  body,  he,  however,  does  not  differ 
fiom  the  text. 


Chap.  Vlt]  SARIRA   STHANAM.  TQ; 

in  each  of  the  two  Utkshepa-Marmas,  one  in  each  of  the 
(five)  Simanta-Marmas  and  one  in  the  Adhipati-Marma, 
should  be  held  unfit  for  the  purpose.  No  incision  or 
opening  should  be  made  into  any  of  these  fifty  vessels 
situated  in  the  region  above  the  clavicles.     23-31. 

Memorable  verses  :— As  the  stem  and  leaves 
etc,  of  a  lotus  plant,  originated  from  its  bulb,  spread 
over  the  whole  surface  of  a  pool  or  tank  (lit :  water), 
so  the  vessels  emanating  from  the  umbilicus  of  a  man 
spread  over  his  whole  organism.     32. 

Thus  ends  the  seventh  Chapter  of  the  S'arira  Slhanam  in  the 
Sus  ruta  Samhila  which  treats  of  the  description  and  classification  of 
S'iras  (vessels). 


CHAPTER  VIII. 

Now  we  shall  discourse  on  the  Sariram  which  treats 
of  the  method  of  Venesection  etc.    (^ira-Vyadha- 

Vidhi-^ariram).    i 

Persons  unfit  for  Venesection:— The 

vessel  or  vessels  (Sira)  of  an  infant,  an  old  man,  a  per- 
ched man,  one  fatigued  and  emaciated  with  endocarditis 
(Kshata-kshina),  a  person  of  timid  or  coward  disposition, 
a  person  used  up  with  excessive  drinking  or  sexual 
enjoyments  or  tired  with  the  troubles  of  long  journey, 
an  intoxicated  person,  a  patient  who  has  been  treated 
with  purgatives,  emetics  or  with  Anub^isana  and 
Asthdpana  measures  (enemas),  a  man  who  has  passed 
a  sleepless  night,  an  impotent  (Kliva)  or  emaciated  person, 
an  enceinte,  or  one  afflicted  with  cough,  asthma,  high 
fever,  phthisis  convulsions,  paralysis,  thirst,  epilepsy, 
or  effects  of  fasting,  should  not  be  pierced  or  opened. 
Incisions  should  not  be  made  into  those  veins  (Siras) 
which  are  not  fit  for  opening,  or  into  the  fit  ones,  if 
invisible  ;  it  should  be  the  same  with  those  which  cannot 
be  properly  ligatured  or  even  if  ligatured  cannot  be 
raised  up.     2. 

Diseases  which  are  amenable  to  acts  of  venesection 
have  been  described  before  (Sonita-Varnaniya-Adhydya). 
Venesection  may  be  performed  in  the  said  diseases  as 
well  as  in  those  which  have  not  been  enumerated  in 
connection  with  them  and  also  in  other  cases  whether 
suppurated  or  unsuppurated,  if  such  a  proceeding  is 
deemed  necessary  and  after  the  application  of  Sneha  and 
Sveda.  Venesection  should  be  made  even  in  the  cases 
declared  unfit  for  it  (such  as  in  an  infant  etc.)  in  cases  of 


Chap.  VIII.]  SARIRA   STHANAM.  1 99 

blood-poisoning  (such   as  snake-bite    etc.)    and    in    fatal 
diseases  (Vidradhi  etc.).     3-4. 

Preliminary  rules  :  —The  patient  should  be 

duly  fomented  i^Sveda)  atid  anointed  (Sneha)  with  oily 
preparations.  A  liquid*  food  or  diet  consisting  of  articles 
which  are  antidotal  to  the  bodily  principles  (Doshas) 
which  engendered  the  disease  or  Yavagu  (gruel)  should 
be  given  to  him  at  first.  Then  at  the  proper  season  (i.e., 
not  in  the  rainy  or  winter  season  etc.)  the  patient  should 
be  brought  near  the  surgeon  and  made  to  sit  or  lie  down 
and  the  part  to  be  incised  upon  should  be  bound,  neither 
too  loosely  {e.g.,  in  the  extremities  etc.)  nor  too  tightly 
(^.^.,in  the  head  etc.),  with  any  of  the  accessories,  such  as 
cloth,  linen,  skin,  the  inner  fibres  of  a  bark,  creepers  etc., 
so  as  not  to  create  any  pain  or  agitation  in  his  mind. 
Then  the  vein  should  be  duly  opened  with  proper  instru- 
ment (and  with  a  careful  regard  to  the  situation  of  any 
local  Marma).     5 

IVletrical  text  : —Venesection  should  not  be 
performed  in  an  extremely  cold  or  hot,  cloudy  or  windy 
day.  It  is  forbidden  to  open  a  vein  without  necessity 
or  in  a  healthy  person,  or  in  a  disease  in  which  such  as  a 
proceeding  is  absolutely  prohibited.     6. 

The  Yantra-Vidhi  :— The  patient  whose 
vein  is  to  be  operated  upon  should  be  seated  on  a  stool 
to  the  height  of  an  Aratni  (distance  of  the  elbow  from 
the  tip  of  the  small  finger)  with  his  face  turned  towards 
the  sun.  He  should  keep  his  legs  in  a  drawn  up  or 
contracted  posture  resting  his  elbows  (Kurpara)  on  his 
knee-joints  and  the  hands  with  his  two  thumbs  closed 
in  his  fists  placed  on  (the  upper  ends  of;  his  Manyas 
(sterno  mastoid  muscles),     Then  having  cast  the  binding 

*  A  liquid  food  is  recommended  for  the  purpose  of  liquefying  the 
blood  so  as  to  bleed  easily.     .  .  - 


200  THE  SUSHRUTA  SAMHITA.  [Chap.  VIII. 

linen  on  the  two  closed  fists  thus  placed  on  the  neck,  the 
surgeon  should  ask  another  man  from  the  back  side  of 
the  patient  to  take  hold  of  the  two  ends  of  the  cloth 
with  his  left  hand  having  the  palm  turned  upward,  and 
then  ask  him  to  tie  up  with  his  right  hand  the  bandage 
round  the  part,  neither  too  diffusely  nor  too  tightly  nor 
too  loosely,  so  as  to  raise  the  vein  and  to  press  the 
bandage  round  the  back  for  a  good  out-flow  of 
blood.  Then  he  (surgeon)  should  perform  the  operation 
in  the  desired  spot,  the  patient  having  been  previously 
asked  to  sit  with  his  mouth  full  of  air  {i.e.,  he  should 
confine  his  breathing  till  the  surgical  operation  is  com- 
pleted). This  proceeding  should  be  adopted  in  opening 
any  vein  of  the  head,  save  those  which  are  situated  in  the 
cavity  of  the  mouth .     7. 

In  the  case  of  opening  a  vein  (Sird)  in  the  leg,  the 
affected  leg  should  be  placed  on  a  level  ground,  while 
the  other  leg  should  be  held  in  a  somewhat  contracted 
posture,  at  a  little  higher  place.  The  affected  leg  should 
be  bound  with  a  piece  of  linen  below  its  knee-joint 
and  pressed  with  the  hands  down  to  the  ankle.  A  liga- 
ture of  the  above  kind  should  then  be  tied  four  fingers 
above  the  region  to  be  incised  upon,  after  which  the 
vein  should  be  opened.    8. 

In  the  case  of  opening  a  vein  (Sira)  in  the  arms, 
the  patient  should  be  caused  to  sit  easily  and  fixedly 
with  his  two  thumbs  closed  in  his  fists  (as  above). 
A  ligature  ol  the  above-mentioned  kind  (rope  etc.,) 
should  be  tied  (four  fingers  above  the  part  to  be  incised 
upon  and  the  vein  opened  in  the  aforesaid  manner. 
The  knee-joint  and  the  elbow  should  be  held  in  a 
contracted  or  drawn  up  posture  at  the  time  of  opening 
a  vein  in  a  case  of  Gridhrasi  (Sciatica^  and  Vis'vachi, 
respectively.    The  patient   should  hold   his  back  raised 


Chap.  Vlli.]  SARTRA   STIIANAM.  201 

up  and  expanded  and  his  h^ad  (and  shoulders)  bent  down 
at  the  time  of  opening  a  vein  in  the  back,  shoulders  and 
the  Sroni  (hips).  He  should  hold  his  head  thrust  back 
and  his  chest  and  body  expanded  at  the  time  of  open- 
ing a  vein  in  the  chest  or  in  the  abdomen.    9-12. 

He  shall  embrace  his  own  body  with  his  arms  at  the 
time  of  opening  a  vein  in  his  sides.  The  penis  should 
be  drawn  downward  (2>.,  in  an  flaccid  state)  on  a 
similar  occasion  in  that  region.  The  tongue  should  be 
raised  up  to  the  roof  of  the  mouth  and  its  fore-part 
supported  by  the  teeth  at  the  time  of  opening  a  vein  in 
its  under-surface.  The  patient  should  be  told  to  keep  his 
mouth  fully  open  at  the  tim^  of  opening  a  vein  in  the 
gums  or  in  the  palate.  Similarly  a  Surgeon  should  devise 
proper  and  adequate  means  for  the  purpose  of  raising 
up  (distinct  appearance  of)  a  Sira  (vein)  and  determine 
the  nature  of  the  bandao'e  to  be  used  therein  accordinor 
to  the  exigencies  {i.e.,  the  health  and  the  kind  of  diseases 
of  the  patient),  of  each  case.     1 3-17. 

An  incision  to  the  depth  of  a  barley-corn  should  be 
made  with  a  Vrihimukha  instrument  (Into  a  vein 
situated)  in  the  muscular  parts  of  the  body,  whereas  the 
instrument  should  b3  thrust  oily  half  that  depth  or  to 
the  depth  of  a  Vriki  seed  in  other  places  (Vrihi  here 
signifies  S'likadkdnya  as  well  as  Rakta-s':ali\  An  inci- 
sion over  a  bone  should  be  made  with  the  Kutharikd 
(small  surgical  axe)  to  the  half  depth  of  a  barley- 
corn.    18-19. 

IVIemorable  Verses  :— An    opening   should 

be  effected  in  such  a  day  in  the  rainy  season  as  would 
be  devoid  of  the  rumblings  of  a  thunder-cloud,  during 
the  cold  (2>.,  in  the  fourth)  part  of  the  day  in  summer, 
and  at  noon  in  the  winter  season  (Hemanta).  These 
are  the  only  three   times    of   opening    a    vein.     A   well 

26 


202  TiiE   SIJSHRUTA  SAMHITA.  [Chap.  VIII. 

and  successfully  pierced  vein  bleeds  in  streams  (almost 
simultaneously  with  the  thrusting  of  the  knife)  and 
spontaneously  stops  after  a  Muhurta  (a  little  while).  The 
vitiated  blood  is  seen  first  to  flow  out  of  an  opened 
vein,  like  the  drop  of  yellow  pigment  first  coming  out  of 
a  Kusumhha  flower.  Blood  does  not  flow  out  from  an  in- 
cision made  into  a  vein  of  an  unconscious  (Murchchhita), 
much  frightened,  or  a  thirsty  patient.  An  incision  of  a 
vein  without  proper  bandaging  and  raising  up  is  attend- 
ed with  a  similar  result.     20-23. 

A  weak  person,  or  one  afi"ected  with  the  unusual 
derangement  of  the  bodily  Doshas  etc.,  or  one  fainted 
(under  operation),  should  not  be  subjected  to  a  measure 
of  continuous  blood-letting  at  a  time ;  instead  of  that, 
the  vein  should  be  opened  afresh  in  the  same  afternoon 
or  on  the  following  day,  or  on  the  third  day  (as  the  exi- 
gency requires).  An  intelligent  surgeon  should  not 
allow  the  flow  of  blood  to  an  excess  but  should  stop 
the  flow  even  with  a  remnant  of  the  diseased  blood  in 
the  system  and  administer  soothing  internal  remedies 
(Samsamana)  for  the  purification  of  the  diseased  rem- 
nant. Bleeding  to  the  quantity  of  a  Prastha*  measure 
should  be  deemed  sufficient  for  a  strong  and  adult  patient, 
stuffed  with  a  large  quantity  of  the  deranged  Doshas  (in 
the  body).     24-26. 

The  vein  should  be  incised  with  a  Vrihimukha  instru- 
ment at  a  distance  of  two  fingers  above  the  seat 
of  the  Kshipra-marma  in  such  diseases  as  Padadaha, 
Pada-harsha,  Ava-vahuka,  Chippa,  Visarpa,  Vata-rakta, 
Vdta-kantaka,  Vicharchika,  Padadari  etc.  The  mode 
of  opening  a  vein  in  the    case  of  Slipada  (Elephantiasis) 

*  In  medicinal  preparalions,  a  Praslha  measure  is  understood  to  be 
four  seers  in  the  case  of  liquids,  but  in  Cises  of  excreta  due  to  emetic  and 
purgative  measures  and  of  blood-lettiDg,  a  Prastha  m  meant  to  be 
thirteen  Palas  and  a  half  only. 


[Chap.  VIII,  SARIRA  STHANAM, 


203 


would  b2  described  under  the  treatment  of  that  disease. 
In  Vata-rogas,  such  as  Kroshtuka-s'irah  (Synovites), 
maimedness  (Pangu)  and  lameness  (Khanja\  the  Siia 
(vein)  of  the  Jangha  (lower  leg-calf),  four  fingers  above 
the  Gulpha,  should  be  opened.  In  cases  of  Apachi 
(scrofula),  the  vein  should  be  opened  simultaneously  with 
the  appearance  of  the  disease  two  fingers  below  the 
Indravasti-marma.  In  a  case  of  Gridhrasi  (sciatica), 
the  vein  should  be  opened  four  fingers  above  or  below 
the  Jdnu  (knee-joint).  In  a  case  of  goitre,  the  veins 
attached  to  the  roots  of  the  Uru  (thighs)  should  be 
opened.  The  instructions  regarding  the  opening  of  a 
vein  in  one  leg  shall  hold  good  in  the  case  of  that  in 
the  other,  as  well  as  in  cases  of  those  situated  in  the 
two  upper  extremities  (hands),  but  the  speciality  is  that 
in  a  case  of  enlarged  spleen,  the  vein  near  the  Kurpara- 
sandhi  (elbow-joint)  of  the  left  hand  or  that  inside  the 
fourth  and  the  fifth  fingers  should  be  opened.  Similarly 
in  a  case  of  Yakriddalyodara  or  Kaphodara,  the  corres- 
ponding vein  in  the  right  hand  should  be  opened. 
Several  authorities  advise  the  opening  of  the  same  vein 
in  cases  of  cough  and  asthma*  due  to  the  action  of  the 
deranged  Kapha.     27-35. 

In  a  case  of  Vis'vachi,  the  same  argument  holds  good 
(four  fingers  above  or  below  the  Kurpara-sandhi)  as  in 
a  case  of  Gridhrasi.  In  a  case  of  Pravdhikd  (diarrhoea) 
attended  with  Sula  (colic),  the  vein  within  two  fingers 
width  around  of  the  Pelvis  (Sroni)  should  be  opened. 
The  vein  of  the  penis  should  be  opened  in  a  case  of 
Parikartikd  (D.R.-ParivartikA),  Upadansa,  Suka-dosha 
and  seminal   disorders.      The   vein    on   either  side  of 

*    Gayi  holds  that  in  cases  of  asthma  and  cough  venesection  should 
be  had  recourse  to  only  when  they  are  in  a  mild  form. 


204  THE  SUSHRUTA  SAMHITA.  Chap.  VIII.] 

the  scrotum  should  be  opened    in   a    case   of    hydrocele 
(Mutra-Vriddhi).     36-39. 

The  veui  four  fingers  below   the   navel    and    on    the 
left  side  of  the  Sevani  (suture)    should    be    opened    in    a 
case    of    Dakodara    (ascites).      In    a    case    of    internal 
abscess  and  colic  in  the  sides  (Pleurodynia),  the  vein    in 
the     region    between   the    breast   and    the    left    armpit 
should  be  opened.     Several  authorities  assert  that   in   a 
case  of  Avavahuka  and  Vahusosha  (atrophy  of  the  hand), 
the     vein    between     the    Amsas   (shoulders)  should    be 
opened.    In  a  case  of  Tritiyaka  (Tertian)  fever^  the  vein 
inside  the  Trika-Sandhi  should  be    opened.     In    a    case 
of  Chaturthaka  fever,  a  vein  jo  hied  with   either    side   of 
and  below  the  shoulder-joint  should   be    opened.     In    a 
case  of  Apasmara,  the  middle  vein    adjacent  to  the  joint 
of  the  jaw-bones  (Hanu-Sandhi)  should  be   opened.     In 
a  case  of  insanity  and  hysteria*   (Apasmara),  the    vein 
between  the  temple  and  the  edge  of  the  sculp   or   those 
in  the  Apanga  (tips  of  the   eyes),  the   forehead    or   the 
chest  should  be  opened.     In  cases  of  the  diseases  of  the 
tongue  and  the  teeth,   the    veins    on   the    under-surface 
(Adho-Jihva)   of    the   tongue   should    be   opened.      In 
the  case  of  a  disease  of  the  palate,  the  local    vein  should 
be  opened.     In  diseases    of  the   ears    and   specially    in 
a  case   of    inflammatory  ear-ache  (Karna-Sula),  the  vein 
along  the  region  above  the  ears  should    be  opened.     In 
diseases  of  the  nose  and  specially  in  a  case    of   the    loss 
of  the  smelling  faculty,  the  vein  at  the  tip   of  the   nose 
should  be   opened.     In    cases   of  eye-diseases,   such   as 

*  Dallana,  however,  differs  here  from  the  text.  He  says,  on  the 
authority  of  Vagbhata,  that  the  opening  of  a  vein  between  the  temple  and 
the  edgt  of  the  sculp  or  those  in  the  Apanga,  the  forehead  and  the  chest 
should  te  recommended  in  cases  of  insanity  only,  and  not  in  the  case  of 
of  .^pas^mdra  as  well  (as  in  the  text). 


Chap.  VIII.]  SARIRA   STHANAxM.  205 

Timira  (blindness),  Akshipdka  (ophthalmia)  etc.,  as  well 
as  In  diseases  of  the  head  and  in  Adhimantha,  the  veins 
about  the  nose,  the  forehead  and  the  Apdnga  (the 
outer  canthus  of  the  eyes),  should  be  opened.     40-51. 

Defective  Venesection  :— Now   we  shall 

describe  the  twenty  kinds  of  defects  relating  to  an 
opened  vein  (Dushta-vyadhana;.  They  are  as  follows  : — 
Durviddha,  Atividdha,  Kunchita,  Pichchita,  Kuttita, 
Aprasrutd,  AtyudirnA,  Ante-abhihata,  Parisushka, 
Kunita,  Vepita,  Anutthita-viddhd,  Sastrahata,  Tiryag- 
viddhd,  Apavlddlia,  Avy^dhyd,  Vidrutd,  Dhenukd, 
Punhpunarviddha  and  Marmaviddha,  i.e.,  incised  about 
the  Sira-marma,  the  Sn^yu-marma,  the  Asthi-marma 
and  the  Sandhi-marma.     52-53. 

Their  definitions  :— The  vein  in  which  an 
act  of  venesection  is  unattended  with  a  satisfactory 
outflow  of  blood  owing  to  its  being  incised  with  an 
extremely  slender  instrument  and  is  marked  by  an 
extremely  painful  swelling  in  consequence  thereof,  is 
called  Durviddhat  (badly  incised).  The  vein  in  which 
the  incision  becomes  excessive  and  no  blood  comes  out 
properly  or  enters  an  internal  channel  owing  to  the 
largeness  of  the  incision,  is  called  Atividdha^  (over-in- 
cised). An  opened  vein  in  which  the  incision  has  been 
made  in  a  curving  manner  and  is  attended  with  the  fore- 
going results,  is  called  Kunchitai  (crooked  or  contracted). 
An  incised  vein  presenting  a  flattened  or  thrashed  ap- 
pearance on  account  of  its  being  opened  with  a  blunt 
knife  (Kantha-Sastra)  is  called  Pichchitai  (thrashed). 
The  vein  at  the  sides  of  which  incisions  have  been 
successively  made,  instead  of  in  its  body,  is  called 
Kuttitat  (lacerated).  An  incised  vein,  unattended  with 
any  bleeding  owing  to  the  patient's  fright,  coldness  or 
loss  of  consciousness,   is  called  Aprasrulai  (unbleeding). 


2o6  THE   SUSHRUTA   SAMHITA.  [Chap.  VIII. 

A  vein  with  a   large    incision  in    its    body    made    with 
a  sharp  and  flat-edged  instrument,  is  called    Atyudirnat 
(improperly     wide-incised).     An  opened    vein  in  which 
blood     oozes     out    in    small    quantity  is    called    Ante- 
abhihatat  (struck    in    the    interior).     An    opened    vein 
in    an    anaemic   patient   (marked    by    a    total      absence 
of    bleeding   and)   stuffed   with   Vayu   (lit.,    as   if    the 
flow     has     been     dried     up     by   the    Vayu),   is    called 
Paris'ashkaL  (dried  up).     A  vein  opened  but  to  a  quarter 
part   of  the    proper   length    and  attended  with  a  scanty 
outflow  of  blood,  is  called  Kunitai  (partially  incised).    A 
vein  which  trembles  owing  to  its  being    bandaged    at    a 
wrong   place    and    from  which   blood  does  not  flow  out 
in  consequence,   is  called    VepitaL   (quivering i.     A    vein 
incised  without  being  previously  properly  raised  up    and 
attended  with  a  similar  result  (ie.,  absence  of  blood),    is 
called    Auutthita-viddha^.     A  vein   cut   into   two   and 
attended   with   excessive   bleeding  and    inoperativeness 
of  the  organ  is  called    Sastrahata'   (knife-cut).     A    vein 
incised    with     an     instrument   applied    slantingly   and 
(consequently)  not  fully  opened,  is  called  Tiryagf-viddha' 
(obliquely     incised),      A      vein    incised    several    times 
and  (every  time)  with  an  improper  instrument,    is  called 
Apaviddhat  (wrongly  incised)     A  vein  unfit  for  opening 
{i,e.,  whose  opening  has  been  forbidden  in    the    Sastras\ 
is  called  Avyskdhyai  (unfit  for  opening),     A  vein    opened 
carelessly    and    hastily    is  called    Vidrutai  (erratic).     A 
vein  bleeding  continuously  owing  to  its  being  repeatedly 
pressed    and    successively   opened,   is  called    Dhenuksi. 
A  vein  variously   cut    owing   to    its  being  pierced    into 
the  same  part  with  an  extremely  slender-pointed  instru- 
ment, is  called  Panah-punarvidahsi  (repeatedly  incised). 
If  a  vein  in  the   Sn^yu-marmas,  the  Asthi-marmas,  the 
SirA-marmas  or  the   Sandhi-marmas   be   opened,   it   is 


Chap.  Vllt.]  SARtRA   STIIANAM.  20/ 

called  Marma-viddhai  and  in  such  cases  severe  pain, 
emaciation  (Sosha)  deformity  or  (even)  death  may  be 
the  result.     54. 

Memorable  Verses  :  —Practice  (even)  docs 

not  give  the  necessary  skill  in  surgical  operation  of  the 
veins  etc.,  as  they  are  naturally  unsteady  and  changing 
like  fishes.  Hence  a  vein  should  be  opened  with  the 
greatest  care.  An  opening  into  the  body,  made  by  an 
ignorant  and  unskilful  surgeon,  is  attended  with  the 
aforesaid  dangers  and  many  other  distresshig  symptoms. 
An  act  of  venesection,  properly  performed,  gives  more 
speedy  relief  than  that  derived  from  the  application  of 
medicated  oil  &c.,  or  of  plaster  as  well.  Venesection 
(bleeding)  properly  performed  is  half  of  the  treatment 
described  in  surgery  like  the  application  of  Vasti- 
karmas  (enematic  measures)  in  therapeutics.     55. 

A  man  medically  anointed  (Sneha-karma),  diapho- 
rised  (Sveda\  vomited  (Vamana),  purged  (Virechana), 
or  treated  with  both  the  Vasti-karmas  (Anuvasana  and 
Asthdpana)  or  bled  shall  forego  anger,  physical  labour, 
sexual  intercourse,  sleep  in  the  day  time,  excessive 
talking,  physical  exercises,  riding  or  driving  etc.,  sitting 
on  his  haunches,  frequent  ramblings,  exposure  to  cold, 
winds  and  the  sun,  hardly  digestible,  uncongenial  and 
incompatible  food  until  the  strength  is  perfectly  restored 
or,  according  to  some  authorities,  for  a  month.  These 
subjects  will  be  fully  dealt  with  later  on  Aturopa- 
drava-chikitsa,  ch. — 39).     56. 

Memorable  Verses  :— The   vitiated  blood 

incarcerated  in  any  part  of  the  body  should  be  abstract- 
ed therefrom  by  scarifying  it,  by  cupping  it  with  a 
Sira  (pipe),  a  horn,  a  gourd,  or  leeches,  or  by  the  opening 
of  a  vein  respectively,  according  to  the  density  of  the 
blood.     (Others  assert  that)  leeches  should  be  applied  in 


208  THE  SUSHRUTA  SAMHITA.  [Chap.  Vlll. 

the  case  of  the  (vitiated)  blood  being  confined  deep 
into  the  body,  scarification  with  a  surgical  instrument 
should  be  made  in  the  case  of  clotted  blood,  with  a  pipe 
in  the  case  of  extensive  vitiation  of  the  blood  through- 
out the  body  and  with  a  horn  or  a  gourd  in  the 
case  of  the  deranged  blood  having  been  seated  in  the 
skin.     57-58. 

Thus   ends   the   eighth  Chapter  of  the  S'arira  Sihanam  in  the  Sus'ruta 
Samhita  which  treats  of  venesection. 


CHAPTER  IX. 

Now  we  shall  discourse  on  the  Sctriram  which  treats 
of  the  description  of  the  arteries,  nerves  and  ducts,  etc.* 

(Dhamani-Vyakarana-^ariram).    r. 

There  are  twenty-four  Uhamanies  (ducts)  in  all,  and 
all  of  them  have  their  origins  in  the  naval  region 
(which  includes  the  whole  abdominal  region*|-).  Several 
authorities  assert  that  no  arbitrary  distinctions  should 
be  made  among  the  Siras  (veins),  Dhaman is  (arteries), 
and  the  Srotas,  (channels),  since  Dhamanis  and  Srotas 
are  but  different  modifications  of  one  original  kind 
of  Sira  (vessels).  But  this  opinion  is  not  a  sound  one 
inasmuch  as  they  have  got  different  natures,  origins 
and  functions  and  as  being  described  so  in  the  Ayurveda. 
But  owing  to  their  adjacent  positions,  the  existence 
of  several  authoritative  dicta  (Apta-vak)  regarding  the 
oneness  of  their  character,  similarity  of  their  functions, 
and  the  minute  nature  of  their  shape,  they  appear  to 
be  homologous  in  their  action,  even  amidst  the  real 
diversities  in  their  work  and  office.     2. 

Of  the  twenty-four  Dhamanis,  which  (originally) 
have  their  roots  in  the  naval  region  (Nabhi),  ten 
have  upward  course,  ten  have  downward  course,  and 
four  flow  laterally  or  transversely.     3. 

Functions  of  the  up-coursing  Dha- 
manis:— The   ten   up-coursing    Dhamanis     (nerves) 

*  Sans.  Dhama— to  be  filled  with  air,  so  called  from  the  fact 
of  their  being  distended  with  air  after  death. 

t  So  far,  as  in  foetal' life,  allantoic  arteries  and  ihe  unbilical  veins 
subserve  the  purposes  of  nutrition,  excretion,  etc  ,  and  reflects  the  rudi- 
mentary  vascular  system. 

2; 


210  THE  SUSHRUtA  SAMHITA.  [Chap.  IX. 

perform  such  specific  functions  of  the  body,  as  sound, 
touch,  taste,  sight,  smell,  inspiration,  sighing,  yawning, 
sneezing,  laughter,  speech,  and  weeping,  etc.,  and  tend  to 
maintain  the  integrity  of  the  body.  These  Dhamanis, 
reaching  the  heart,  respectively  ramify  themselves  into 
three  branches,  thus  making  thirty  (ramifications  in  all). 
Ten  of  these  serve  the  following  purposes,  viz  ,  two  serve 
as  the  channels  of  the  bodily  Vayu,  two  of  the  Pitta, 
two  of  the  Kapha,  two  of  the  blood,  and  two  of  the 
Rasa  (lymph  chyle).  Eight  of  the  remaining  ones 
(twenty),  serve  the  following  functions,  viz.^  two  of  them 
cany  sound,  two  sight  or  colour,  two  smell,  and  two 
taste.  Moreover  a  man  speaks  with  the  help  of  another 
two,  makes  sound  with  the  help  of  another  couple, 
sleeps  through  the  instrumentality  of  another  pair 
(couple),  and  wakes  up  with  the  help  of  another  couple. 
Two  of  the  Dhamanis  (ducts)  carry  the  fluid  of  lachry- 
mation,  two  of  them  (ducts),  attached  to  the  breasts 
of  a  woman,  cany  milk  of  her  breasts,  which,  coursing 
through  the  breast  of  a  man,  convey  his  seminal  fluid. 
Thus  we  have  described  the  thirty  Dhamanis  with 
their  ramifications.  These  sustain  and  maintain  the 
integrity  (of  the  limbs  and  members  of  the  body)  above 
the  (line  of)  umbilicus,  such  as  the  Udara,  the  sides, 
the  back,  the  chest,  the  neck,  the  shoulders  and  the 
arms.     4. 

IVIcmorabIcVcrSe:—Theup-coursing  Dhama- 
nis duly  perform  the  offices  stated  above.  Now  I 
shall  describe  the  specific  functions,  etc.,  {i.e,,  nature, 
office,  and  situations,  etc.,)  of  the  down-coursing  ones.  5. 

Functions     of    the    down -coursing 

Dhamanis  : — The  down-coursing  Dhamanis  res- 
pectively form  the  channels  for  the  downward  conveyance 
of  Vayu  (flatus),   urine,  stool,   semen,  and    catamenial 


Chap.  IX.]  SARIRA  STHANAM.  211 

fluid,  etc.  These  Dhamanis  reaching  down  into  the 
PittAsaya  (receptacle  of  the  Pitta)  separate  the  serum 
prepared  out  of  the  food  and  drink  through  the  agency 
of  the  local  heat  (and  pitta),  and  carry  it  to  the  remotest 
parts  of  the  organism  maintaining  their  healthy 
moisture,  supplying  them  with  the  necessary  principles 
of  nutrition  and  (ultimately)  conveying  them  to  the  up- 
coursing  and  lateral  Dhamanis,  in  order  to  be  conveyed 
to  the  parts  traversed  by  them  respectively.  Thus  they 
indirectly  serve  to  supply  the  heart  with  its  quota  of 
healthy  Rasa  (serus  fluid),  if  not  in  a  direct  way.  Moreover 
they  tend  to  separate  the  efifetematter  (urine,  stool  and 
sweat)  from  the  fully  transformed  lymph-chyle  in  the 
abdomen,  the  stomach  and  the  small  intestines  (Amds'aya 
and  Pakvas'aya).  Each  of  the  down-coursing  Dhamanis 
is  found  to  ramify  into  three  branches  at  a  place  midway 
between  the  Amas'aya  (stomach)  and  the  Pakvds'aya 
(intestines).  Thus  they  number  thirty  in  all.  The 
functions  of  the  ten  out  of  these  (thirty  vessels)  are  as 
follows,  viz.,  two  serve  to  carry  Vdyu,  two  Pitta,  two 
Kapha,  two  blood,  and  two  Rasa  (lymph-chyle).  Two  of 
these  Dhamanis,  running  into  the  intestines,  carry  the 
food,  another  two  carry  the  Toya*  (watery)  part,  another 
two,  running  into  the  bladder,  serve  to  carry  out  the 
urine  (from  the  bladder),  another  two  carry  the  semen, 
and  another  two  serve  as  the  channels  of  transmission 
and  emission  of  the  same  fluid  and  serve  to  carry  the 
ovarian  discharge  in  women.  The  two  Dhamanis,  attached 
to  the  large  intestine  (Sthulantra),  serve  as  the  channels 
of  faecal  matter,  while  the  remaining  eight  convey 
perspiration  to  the  lateral-coursing  Dhamanis,  Thus  we 
have  finished  describing  these  thirty  Dhamanis  with 
their  ramifications.  These  sustain  and  maintain  the 
*    Xhi,s  watery  p^rt  reaching  the  bladder  is  tKansformed  into  urine, 


212  THE  SUSHRUTA  SAMHITA.  [Chap.  IX. 

integrity  of  the  parts  of  the  body  below  the  naval 
region,  such  as  the  Pakvasaya  (Intestine),  the  waist,  the 
organic  principles  of  stool  and  urine,  the  organs  of 
generation,  the  anus,  the  bladder,  and  the  lower  limbs  of 
the  body  (Sakthi)  (according  to  their  utility  in  the 
physical  economy  of  the  organism).     6. 

Memorable  Verse  ;— These   down-coursing 

Dhamanis  perform  the  afore-said  functions.  Now  I 
shall  describe  the  specific  functions  {i.e.,  nature,  office, 
and  situations,  etc.,)  of  the  lateral-coursing  Dhamanis.  7. 

Functions   of    the    lateral-coursing* 

Dhamanis: — The  four  lateral-coursing  Dhamanis, 
gradually  ramifying  themselves  into  hundreds  and 
thousands  of  branches,  simply  baffle  counting.  The 
net-work  of  these  Dhamanis  spreads  over  the  whole 
orgnism  and  maintain  its  integrity.  Their  exterior 
orifices  are  attached  to  the  roots  of  hairs  (pores  of  the 
skin)  through  which  they  convey  the  perspiration  and 
the  Rasa  (serum),  thus  supplying  the  body,  both  inter- 
nally and  externally,  with  the  soothing  nutritions 
(moisture  of  healthy  lymph-chyle).  The  effects  and 
potencies  of  the  articles  of  anointment,  sprinkling, 
immersion,  and  plasters,  enter  through  these  orifices 
into  the  internal  organism  through  the  agency  of  the 
heat  in  the  skin,  and  sensations  of  a  pleasant  or 
painful  contact  are  experienced  through  their  instru-: 
mentality.  Thus  we  have  finished  describing  the  four 
lateral-coursing  Dhamanis  with  their  ramifications 
throughout  the  whole  organism.     8. 

Memorable  Verses  :— The  Dhamanis  have 
got  pores  in  their  sides  through  which  they  carry 
the  Rasa  (lymph-chyle)  throughout  the  organism,  like 
the  filaments  and  fibres  of  water-lily  and  lotus.  The.'^e 
Phan\anis   furnish   the   self-conscious    Ego,   confined  in 


I 


Chap.  IX.]  SARIRA   STHANAM.  21 3 

the  material  body,  which  is  the  resultant  of  the  combi- 
nation of  the  five  material  elements,  with  a  distinct 
sensation*  peculiar  to  each  of  the  five  sense-organsf 
and  break  up  the  combination  (of  the  five  material 
elements)  at  the  time  of  death.     9  —  10. 

Now  we  shall  describe  the  symptoms  produced  by  a 
Srota  (duct  or  channel)  pierced  at  its  root  or  starting 
point.  The  ducts  or  channels  respectively  conveying 
the  life,  the  food,  the  water,  (the  organic  principle  of) 
the  Rasa  (serum),  the  blood,  the  muscles,  the  fat, 
the  urine,  the  stool,  the  semen,  and  the  cata- 
menial  blood,  naturally  fall  within  the  scope  of 
Surgery  (Salya-tantra).  Several  authorities  assert  that 
the  Srotas  (vessels)  are  innumerable]:,  and  perform 
different  functions  in  their  different  aspects. 

The  two  Srotas  (channels)  of  Prana  (bronchi)  have 
their  roots  in  the  heart  and  the  Rasa-carrying  Dhama- 
nis  (pulmonary  arteries).  An  injury  to  any  of  these 
Srotas  (vessels)  produces  groaning,  bending  down  of 
the  body,  loss  of  consciousness  (Moha),  illusion,  and 
shivering,  or  may  ultimately  prove  fatal.  The  food- 
carrying  Srotas  (^Esophagus)  have  their  roots  in  the 
Amasaya  (stomach)  and  in  the  food-carrying  Dhamanis 
(intestines).  An  injury  to  or  piercing  of  such  a  duct 
(Srota),  gives  rise  to  tympanites,  colic  pain,  aversion  to 
food,  vomiting,  thirst,  blindness  or  darkness  of  vision,  or 
may  even  end  in  death.  There  are  two  water-carrying 
(Udaka-vaha)  ducts  or  channels  which  have  their  roots 
in    the   palate    and    the    Kloma^    and  a  pie-cing  of  any 

*  Hearing,  touch,  smell,  taste,  and  sight. 

t  Eyes,  ears,  nose,  tongue  and  skin. 

t  But  this  science  does  not  take  any  cognisance  of  them,  since  the 
pain  incidental  to  a  piercing  of,  or  an  injury  to,  any  of  these  extremely 
attenuated  channels,  tnust  be  slight  in  its  character. 


214  THE  SUSHRUTA  SAMHITA.  [Chap.  IX. 

of  these  makes  the  patient  thirsty  and  ends  in  his  instan- 
taneous  death    (/.  e ,    within  seven  days).     The    serum- 
carrying   (Rasa-vaha)   ducts    are    two   in   number   and 
have   their  roots  in    (the   viscus    of)    the   heart    and    the 
serum-carrying  Dhamanis  (vessels).     An    injury   to    or 
piercing  of  any  of  these  ducts  gives  rise  to  Sosha   (con- 
sumption) and  symptoms  identical  with  those  developed 
by  a   hurt   to   the    Prana-vaha    channels    of    the   body, 
ending  in  death.     The  blood-carrying  Srotas  (channels) 
are  two  in  number  and  have  their  roots  in  the  spleen  and 
the   liver,  and   the  blood-carrying  Dhamanis  (capillaries 
in  general).     An    injury   to   any    of   these    channels   is 
attended   with    pallor,   bluishness   of  complexion,  fever, 
burning  sensations,  excessive  haemorrhage,  and    redness 
of  the  eyes.     The  two  muscle-carrying  Srotas  (ducts  or 
channels)    have     their    roots    in     the   (Sndyu),   nerves 
Tvak      (serum),     and     the     blood-carrying     Dhamanis 
(capillaries).     An  injury    to    any    of   these    channels    is 
characterised  by  swelling,  loss  or  atrophy  of  the  muscles, 
appearance  of  varicose  veins  or  may    (ultimately)   resu't 
in  death.     The  fat-carrying    Srotas  (ducts)  are  two   in 
number   and    have    their  roots  in  the  region  of  the  Kati 
(waist)  and  the  Vrikkas    (kidneys).     An    injury   to  any 
of  these  bring  in  (a    copious    flow   of)    perspiration,  oily 
gloss    of  the   skin,    parched    condition    of   the    palate, 
extensive   swelling    (of   the  affected  locality)  and  thirst. 
The  two   urine-carrying    Srotas   (channels)   have  their 
roots  in  the  bladder  and  the  penis    (urethra).    An  injury 
to  any  of  these  is  marked  by  constipation  or  epistaxis 
in  the  bladder,  retention  of  urine,  and    numbness  of  the 
genitals.     The  two  stool-carrying  Srotas  (ducts)   have 
their   roots    in    the    Guda     (anus)    and    the    Pakvas'aya 
(intestines)  ;   an  injuiy  to  any   of  these  is  characterised 
by  complete   retention   of  st;ool   (in  the  bo\vels),  accom- 


Chap.  I)?.]  SARIRA  STHANAM.  ^I5 

panied  by  a  distention  of  the  abdomen,  foul  smell  and 
intussusception  of  the  intestine  (as  in  a  case  of  ententes). 
The  two  semen-carrying  Srotas  (ducts)  have  their 
roots  in  the  breasts  and  the  testes.  An  injury  to  any 
of  them  leads  to  loss  of  manhood,  delayed  emission 
of  semen,  or  blood-streaked  character  of  that 
fluid.  The  two  Artava- carrying  Srotas  (ducts)  have 
their  roots  in  the  uterus  as  well  as  in  the  Dham.anis 
which  carry  the  Artava  (ovarian  product).  An  injury 
to  any  of  these  brings  on  sterility,  suppression  of 
the  menses  and  incapacity  for  copulation.  A  cutting 
to  the  Sevan!  (median  raphe  of  the  perineum)  exhibits 
symptoms  identical  with  those  of  a  case  of  injured 
bladder  or  anus,  described  before.  A  physician  may 
take  in  hand  the  medical  treatment  of  a  case  of  a  Srota 
which  has  been  pierced,  but  he  shall  not  necessarily 
entertain  any  hope  of  ultimate  success.  (But  time 
works  wonders,  and  such  a  case  may  sometimes  end  in 
recovery).  A  case  of  pierced  duct,  from  which  the 
dart  (Salya,  or  the  like  piercing  matter)  has  been 
extricated,  may  be  medically  treated  (without  holding 
out  any  prospect  of  recovery  to  the  friends  of  the 
patient),  according  to  the  direction  laid  down  under 
the  head  of  ulcer  (^Vrana).     11-12. 

IVIetrical  Text :— The  ducts  emanating  from  the 
cavity  of  the  heart,  other  than  the  Siras  (veins),  Dhaman  is 
(arteries),  and  found  to  course  through  the  whole  body, 
are  called  Srotas  (lit.  channels  or  currents).     13. 

Thus  ends  the  ninth  Chapter  of  the  S'arira  Sthanam  in  the 
Sus'ruta  Samhita  which  treats  of  the  descriptions  of  the  arteries, 
cucts  and  nerves. 


CHAPTER  X. 

Now  we  shall  discourse  on  the  Sdriram  which  treats 
of  the  nursing  and  management,  etc.,  of  pregnant 
women   from    the   day    of    conception    till    parturition 

(Garbhini-Vyakarana-^ariram).     i. 

General  Rules  :— An  cnciente,  from  the  first 
day  of  conception,  should  always  cherish  a  clear  joy- 
ful spirit  in  a  clem  body.  She  should  wear  clean  and 
white  garments,  ornaments,  &c.,  engage  herself  in  the 
doing  of  peace-giving  and  benedictory  rites  and  live  in 
devotion  to  the  gods,  the  Brahmins  and  her  elders  and 
superiors.  She  should  not  touch  nor  come  into  contact 
with  unclean,  deformed  or  maimed  persons,  and  should 
forego  the  use  of  fetid  smelling  things,  avoid  dreadful 
sights  and  painful  or  agitating  sounds  and  the  use  of 
dry,  stale  and  dirty  food  as  well  as  that  prepared 
overnight.  Long  and  distant  walks  from  home,  resorts 
to  cremation-grounds  or  to  a  solitary  retreat,  or  to  a 
Chaitya*,  and  sitting  under  the  shadow  of  a  tree  should 
be  absolutely  forbidden  (to  her  during  the  period  of 
gestation).  Indulgence  in  anger,  fright  or  other  agita- 
ting emotions  of  the  mind  should  be  deemed  injurious. 
To  carry  a  hea  vy  load,  to  talk  in  a  loud  voice  and 
all  other  things  which  might  occasion  injury  to  the 
foetus,  (sexual  intercourse,  &c.)  should  be  refrained  from. 
The  practice  of  constant  anointment  and  the  cleansing 
of  the  body,  &c.,  (with  Amalaki,  Haridrd,  etc.  —lit.  cos- 
metics) should  be  given  up,  All  fatiguing  exercises 
should  be  discontinued  and  the  rules  laid  down    for    the 

*     Chaitya — is  a  haunted  or   diefied    tree,    or   according   to   others  a 
Budhistic  monastery. 


Chap.  X.]  SARIRA   STHANAM. 


217 


guidance  of  a  woman  in  her  menses  should  be  strictly 
adhered  to.  The  couch  and  the  bed  of  a  pregnant 
woman  should  be  low,  soft  and  guarded  on  all  sides  by 
a  number  of  soft  pillows  or  cushions.  The  food  should 
be  amply  sweet,  palatable  (Hridya)*  well-cooked,  pre- 
pared with  appetising  drugs  and  abounding  in  fluid 
substances.  These  rules  should  be  followed  up  till 
delivery.     2. 

Special  regimen    during  the  period 

of  Gestation  :  -During  the  first  three  months  of 
pregnancy  an  enciente  should  partake  of  food  abound- 
ing in  sweet,  cool  and  fluid  articles.  Several  medical 
authorities  recommend  a  food  made  of  Shashtika  rice 
with  milk,  to  be  given  to  her  specially  in  the  third 
month  of  gestation,  with  curd  in  the  fourth,  with  milk 
in  the  fifth  and  with  clarified  butter  in  the  sixth 
month  of  pregnancy.  Food  largely  composed  of 
milk  and  butter,  as  well  as  relishing  (Hridya)  food 
with  the  soup  of  the  flesh  of  jdngala  (wild)  animals 
should  be  given  to  her  in  the  fourth,  food  with  milk 
and  clarified  butter  in  the  fifth,  adequate  quantity 
of  clarified  butter  prepared  with  (the  decoction  of) 
Svadamshtra,  or  gruel  (Yavagu)  in  the  sixth  ;  and  clarified 
butter  prepared  with  (the  decoction  of)  the  Prithak- 
parnyddi  group  in  adequate  quantities  in  the  seventh 
month  of  gestation.  These  help  the  foetal  development. 
For  the  purpose  of  restoring  the  Vayu  of  her  body 
(nervous  system)  to  the  normal  course  and  condition  and 
for  the  cleansing  of  the  bowels,  the  enciente  should  be 
given  an  AsthApana  (enema),  composed  of  a  decoc- 
tion of  Vadara  mixed  with  Vala,  Ativala,  Satapushpa, 
Palala  (flesh),    milk,   cream  of  curd,  oil,  Saindhava  salt, 

*     "Hridya"  here  means  the  diet  in  which  there  is  an   abundance   of 
Ojo-producing  (albuminous)  properties. 

2t 


2l8  THE  SUSHRUTA   SAMHITA.  [Chap.  X. 

Madana  fruit,  honey  and  clarified  butter.  After  that 
she  should  have  an  Anuvdsana  (enema)  made  up  of 
oil  prepared  with  milk  and  decoction  of  the  drugs 
known  as  the  Madhuradi-gana.  This  restores  the  Vdyu 
to  its  normal  course  and  condition,  which  brings  on 
an  easy  and  natural  parturition  unattended  with  any 
puerperal  disorders.  Henceforth  up  to  the  time  of 
delivery  the  enciente  should  have  liquid  food  (Yavagu) 
made  up  of  emollient  substances  (fatsj  and  soup  of  the 
flesh  of  Jangala  animals  (deer,  etc.).  If  treated  on  these 
lines  the  enciente  remains  healthy  and  strong,  and 
parturition  becomes  easy  and  unattended  with  evils. 
An  enciente  should  be  made  to  enter  the  lying-in 
chamber  in  the  ninth  month  of  her  pregnancy  and 
under  the  auspices  of  happy  stars  and  propitious 
lunar  conditions.  The  chamber  of  confinement  (Sutika- 
griha)  in  respect  of  a  Brdhmin,  Kshatriya,  Vais'ya  and 
Sudra  mother  should  be  raised  on  grounds  respectively 
possessed  of  white,  red,  yellow  and  black  soils,  and 
made  of  Vilva,  Vata,  Tinduka  and  Bhallataka  wood. 
Couches  should  be  made  of  these  woods  respectively 
in  cases  of  the  different  social  orders.  The  walls  of 
the  room  should  be  well-plastered  and  the  furniture 
(necessary  accessories)  should  be  placed  tidy  in  their 
proper  places.  The  door  of  a  lying-in  chamber  should 
be  made  to  face  the  south  or  the  east,  and  the  inner 
dimensions  of  the  room  should  be  eight  cubits  in  length 
and  four  in  breadth.  Religious  rites  for  warding  off 
the  visitation  of  evil  spirits  and  malignant  stars  should 
be  undertaken  at  (the  door  of)  the  room.     3. 

Signs  of  imminent  parturition-(M.~- 

T.)  :— A  looseness  of  the  sides  of  the  abdomen  and 
untying  of  the  umbilical  cord  of  the  child  (from  the 
cardiac    cord  of  its   mother)  and    a   perception    of  the 


I 


ap-   ^l  SARlRA   STHANAM.  2tg 

characteristic  pain  at  the  waist  would  indicate  the 
approach  of  the  time  of  delivery.  A  constant  and 
severe  pain  at  the  waist  and  the  back,  constant  (in- 
voluntary) motions  of  the  bowels  and  micturition  and 
mucous  discharge  from  the  vulva  are  the  symptoms 
which  are  manifest  at  the  time  {i.e.,  a  little  before)  of 
parturition.     4-5. 

Preliminary  Measures  :— Rites  of  bene- 
diction should  be  performed  for  the  safety  of  the 
enciente  in  her  travail  and  she  should  be  made  to 
pronounce  benedictory  Mantras  surrounded  by  male 
babies  on  all  sides.  A  fruit  with  a  masculine  name 
should  be  given  in  her  hand.  Her  body  should  be 
anointed  with  oil  and  washed  with  warm  water  and 
she  should  be  made  to  drink  largely  a  gruel  (Yavagu) 
made  of  articles  (which  exert  a  beneficial  virtue  at  the 
time).  Then  she  should  be  laid  on  her  back  on  a  soft 
and  sufficiently  spacious  bed,  her  head  being  placed 
on  a  pillow  and  her  legs  slightly  flexed  and  drawn  up. 
Four  elderly  ladies  with  paired  finger-nails  and  skilled 
in  the  art  of  accouchement  and  with  whom  she  feels 
no  delicacy,  should  attend  and  nurse  her  at  the  time.    6. 

Then  after  having  gently  lubricated  the  mouth  of 
the  parturient  canal  along  the  natural  direction  of  the 
pubic  hairs  (Anuloma)  (so  as  not  to  create  any  discom- 
fort in  the  part)  one  of  them  (elderly  ladies)  should 
address  the  enciente  as  follows  : — "O  fortunate  damsel, 
try  to  bear  down  the  child;  but  do  not  make  such  an 
attempt  in  the  absence  of  real  pain."  On  experiencing 
an  untying  of  the  umbilical  cord  of  the  child,  the 
enciente  should  gently  make  such  urgings,  whenever 
she  will  experience  pain  in  the  pelvic,  pudendal  and 
pubic  regions  and  in  the  region  between  the  neck  of 
the  bladder  and    the   pelvis.     Deep    urgings   should  be 


2^C  THE   SUSHRUtA  SAMttlTA.  Chap.  X.] 

made  on  the  exit  of  the  foetus  out  of  the  uterus, 
and  after  that  deeper  urgings  should  be  made  during 
the  passage  of  the  child  through  the  canal  until 
delivery.  7. 

An  urging  (made  by  the  enciente)  in  the  absence 
of  any  real  pain  may  lead  to  deafness,  dumbness  and 
deformity  of  the  jaw-bones  of  the  child  or  subject 
it  to  attacks  of  cough,  asthma,  consumption,  etc.,  or  lead 
to  the  diseases  of  its  head,  or  to  the  birth  of  a  haunch- 
backed  or  deformed  child.  A  case  of  abnormal  presenta- 
tion (Pratiloma)  should  be  converted  into  the  normal 
or  cephalic  one  (Anuloma)  by  version*     8-9. 

In  the  case  of  protracted  delivery,  e,  g.,  an  obstruc- 
tion of  the  child  at  the  vagina, — the  vagina  should  be 
fumigated  with  the  fumes  of  the  slough  (cast-off  skin) 
of  a  cobra  (snake)  or  with  the  fumes  of  Pinditaka 
(Madana)  or  the  roots  of  Hiranyapushpi  (Kantakdri) 
should  be  tied  (round  the  neck  or  the  waist)  or  Suvar- 
chala  {Atasi)  or  Vis'alyd  (Patald)  should  be  tied  round 
the  hand  (wrist)  and  leg  (ankle)  of  the  parturient 
woman.     10. 

Post-parturient  Measures  :— The  shreds 

or  membranes  lying  on  the  body  of  the  child  should  be 
removed  immediately  after  its  birth  and  its  mouth 
should  be  cleansed  with  clarified  butter  and  rock-salt. 
Then  a  linen  pad  soaked  in  clarified  butterf  should  be 
applied  on  the  head  of  the  new-born  baby.  Then  the 
umbilical  cord,  after  having  been  slightly  drawn  out, 
should  be  ligatured  with  one  end  of  a  string  at  a  point 
eight   fingers    apart     from    its    navel,    the    other     end 

•  The  various  forms  of  (Pratiloma)  abnormal  presentations  have  been 
described  under  Mudha-Garbha  Nidanam  (Nidan-Sthana — Chap.  IX.) 
and  their  treatment  is  to  be  found  in  Chikitsa-Slhana — Chap.  XV. 

t  Ijrahmadcva  recommends  Vala-Taila  instead  of  clarified  butler. 


Chap.  X.]  SARiRA   STUANAM  2^1 

of  the  string  being  tied  round  its  neck  ;  then  the  um- 
bilical cord  should  be  severed  immediately  above  the 
ligature,     ii. 

Natal  Rites  : — Then  having  sprayed  (the  face 
ofj  the  baby  with  cold  water,  the  post-natal  rites  should 
be  performed  unto  it.  After  that  the  baby  should  be 
made  to  lick  an  electuary  composed  of  honey,  clarified 
butter  and  the  expressed  juice  of  Brdhnii  leaves  and 
Anantd,  mixed  with  (half  a  Rati  weight  of)  gold  dust  and 
given  with  the  ring-finger  of  the  feeder.  Then  the  body 
of  the  child  should  be  anointed  with  Vald-taila  and 
it  should  be  bathed  in  an  infusion  of  the  barks  of 
Kshiri  trees,  or  in  the  washings  (decoctions)  of  drugs 
known  as  the  Sarvagandha  (ElAdi  group),  or  in  water 
in  which  red-hot  gold  or  silver  bar  has  been  immersed, 
or  in  a  tepid  decoction  of  Kapittha  leaves,  according 
to  the  nature  of  the  season,  the  preponderance  of  the 
deranged  Doshas  in  its  body  and  according  to  its  physi- 
cal conditions.      12. 

Diet  for  the  Child— (M.—T.)  :— The  milk  in 
the  breasts  of  a  newly  parturient  woman  sets  in  three  or 
four  days  after  parturition  owing  to  the  dilation  of  the 
orifices  of  the  milk  ducts  (galactoferous  ducts).  Hence 
the  baby  should  be  fed  thrice  daily  (morning,  noon 
and  evening)  on  a  handful  (child's  own  hand)  of  clarified 
butter  and  honey  mixed  with  (a  Rati  weight  ofj  pul- 
verized Anantd  roots  sanctified  with  Mantras  on  the 
first  day  ;  and  on  the  second  and  third  days  the  child 
should  be  fed  on  clarified  butter  prepared  with  the 
Lakshand  ,root).  On  the  following  (fourth;  day  the  child 
should  be  fed  on  its  handful  of  honey  and  clarified 
butter  only  twice  (/.  ^.,  in  the  morning  and  at  noon). 
(From  the  evening  of  fourth  day)  the  mother  should 
first  squeeze  off  a  quantity  of  her   milk    and    then    give 


222  THp:  SUSHRUTA  SAMHITA.  CChap.  X. 

the  child    her    breast.     (This    rule    should    be    observed 
at  the  time  of  tending  the  child  every  day).     13-14. 

Treatment  of  the  mother:— The  body 

of  the   mother    should    be    anointed  (after     parturition) 
with   the  Vald-Taila  and    treated   sboth  internally   and 
externally)  with    a   decoction   of  Vayu-subduing  drugs 
(such  as  the  B hadra-D drv ddi  gvou^,  etc.).  If  still  there  be 
any  abnormality  in    the    condition    of  the   Doshas  (the 
discharge   of  vitiated    blood    /  e.,    lochia),   the    mother 
should    be   given  to     drink    a    luke-warm    solution    of 
treacle  mixed  with  powders    of  Pippali,   Pippali   roots, 
Hasti-pippali,    Chitraka   and  S'ringavera,  and  the  medi- 
cine  should    be   continued   for   two   or   three    days   or 
longer,    (if    necessary),   till    the    disappearance    of    the 
vitiated  blood  (lochia).    When  the  discharge  gets  normal 
(i  e.,  on  the  appearance   of  healthy  lochia),  the   mother 
should   be    made    to    take     for   three   days    a     gruel 
(Yavdgu)   prepared    with   the    decoction    of    the    drugs 
constituting  the  Viddri-Gandhddi  Gana  and  mixed  with 
(a  good  quantity  of;  clarified  butter  or  a  Yavagu  prepared 
in  milk.     After  that  a    meal  of   boiled  Sali-rice   and    a 
broth      made     from    the    meats     of    Jangala    animals 
boiled  with  barley,    Kola  and  Ktdattha  pulse,   should  be 
prescribed     for    her,   taking    into      consideration     the 
strength  and   the   condition   of  her   appetite    (Agni   or 
digesting    power).      The    mother    should    observe    this 
regimen  of  diet  and  conduct  for  one  month  and    a  half 
(after   delivery).     After   this   period    she     may      be    at 
liberty   to    choose    any   food    to    her    liking    and  revert 
to   her  natural    mode   of  living.     According    to   several 
authorities,    however,    a   woman    does    not    regain    her 
natural   temperament   of  body   till  the  reappearance  of 
the  healthy  menstruation  (after  parturition).     15. 

A    strong    but   newly   delivered  woman,    born    and 


Chap.  X.]  SARIRA   STIIANAM.  223 

bred  up  in  a  Jdngala  country  should  be  given  to  drink, 
for  three  or  five  nights,  either  oil  or  clarified  butter 
in  an  adequate  quantity  with  an  after-potion  consisting 
of  the  decoction  of  drugs  constituting  the  group  known 
as  the  Pippalyddi  Gana.  She  should  be  daily  anointed 
with  oil,  etc.  If,  however,  of  delicate  health,  she 
should  be  made  to  take,  for  three  or  five  nights  in 
succession,  a  medicated  Yavagu  (gruel)  as  described  in 
the  last  para.  Thenceforth  a  diet  of  demulcent  pro- 
perties should  be  prescribed  for  her  and  her  body 
should  be  regularly  washed  with  a  copious  quantity 
of  tepid  water.  A  mother,  after  parturition,  should 
forego  (for  a  considerable  time)  sexual  intercourse, 
physical  labour  and  indulgence  in  irascible  emotions/ 
etc.     1 6 

lYIemorable  Verses  :— Any  disease  acquired 
by  a  newly  delivered  mother  (Sutika)  by  her  injudicious 
conduct  of  life  soon  lapses  into  one  of  a  difficult  type 
(hard  to  cure) ;  and  it  becomes  incurable  if  it  be  due  to 
too  much  fasting.  Hence  a  wise  physician  should  treat 
her  with  such  measures  as  are  natural  and  congenial  to 
her  temperament,  the  time,  the  place  and  the  nature 
of  the  disease,  so  that  she  may  not  be  afflicted  with  any 
evil  effect.     17. 

A  placenta  retained  in  the  uterus  causes  constipa- 
tion (Anaha)  of  the  bowels  and  distention  of  the 
abdomen  (^tympanitesX  Hence  in  such  a  case  her 
throat  should  be  tickled  with  a  finger  covered  with 
hair  ;  or  the  exterior  orifice  of  the  vagina  should  be 
fumigated  with  the  fumes  of  the  cast-off'skin  of  a  snake, 
Katuka,  Aldvu,  Kritavedhana  and  mustard  seeds  mixed 
with  mustard  oil.  In  the  alternative,  a  plaster  of  Ldngali 

*  Fifteen  kinds   of  emotions  as  described  in  the  thirty-ninth  chapter  of 
ihe  Chikitsa-sthanap,!, 


224  THE  SUSHRUTA  SAMIIITA.  [Chap.  X. 

roots  should  be  applied  to  the  palms  and  soles  of  her 
hands  and  feet  ;  or  the  milky  juice  of  Snuhi  tree 
should  be  applied  over  her  scalp  ;  or  a  compound  made 
of  pasted  Ldngali  roots  and  Kushtha  mixed  with  either 
wine  or  the  cow's  urine  should  be  given  her  for  drink. 
A  Kalka  either  of  S'dli  roots  or  of  the  drugs  con- 
stituting the  Pippalyddi  Gana  mixed  with  wine  (Sura) 
should  be  given  her  for  the  purpose  In  the  alterna- 
tive, an  Asthapana  (enema)  of  white  mustard  seeds 
Kushtha  (Kuda),  Ldngali,  and  the  milky  juice  of  Mahd- 
vriksJia,  mixed  with  Sura-manda  should  be  prescribed. 
(If  the  above  measures  fail)  an  Uttara-Vasti  (uterine 
douche)  prepared  with  the  aforesaid  drugs  and  boiled  in 
mustard  oil  should  be  applied  ;  or  else  the  placenta 
should  be  removed  by  the  hand  lubricated  with  an  olea- 
ginous substance  and  with  the  nails  clipped  off.     i8. 

IVIakkalla    and    its   Treatment :— The 

lochia  of  a  newly  delivered  woman  whose  organism 
has  become  excessively  dry  on  account  of  profuse  use 
of  absorbants  or  deranged  by  any  other  causes, — the 
lochia  being  obstructed  in  its  exit  by  the  local  Vayu, — 
gives  rise  to  Granthis  (nodules)  which  may  appear 
below  the  navel,  on  the  sides  of  the  pelvis  about  the 
region  of  the  bladder  or  of  the  pubis.  Severe  piercing 
pain  (Sula)  is  felt  about  the  region  of  the  navel,  the 
stomach  and  the  bladder  and  a  sensation  of  pricking 
with  needle  and  cutting  pain  in  the  intestines. 
At  the  same  time  the  abdomen  becomes  distended 
with  the  retention  of  urine.  These  are  the  symptoms 
of  Makkalla.  In  such  a  case,  a  decoction  of  the  drugs 
of  the  Viratar-vddi  6^<^;/^  mixed  with  a  powdered  com- 
pound of  the  Ushakddt  Gana  should  be  given  her.  In  the 
alternative,  a  potion  of  carbonate  of  potash  [Yavakshdra) 
dissolved    in    tepid  water  or  in  clarified  butter  ;  of  rock- 


Chap.  X.]  SARIRA  STHANAM.  225 

salt  dissolved  in  the  decoction'of  the  Pippalyddi  Gana ; 
of  a  compound  made  of  the  powdered  drugs  of  the  latter 
Gana  with  Surd-manda  ;  of  the  powders  of  cardamom 
and  PancJici-kolas  dissolved  in  the  decoction  of  the 
drugs  of  the  Vaninddi  Gana  ;  of  the  powders  of  pepper 
and  Bhadraddrii  dissolved  in  the  decoction  of  the 
Prithakparnyddi  Gana  ;  or  of  pulverized  Trikatu^ 
Chaturjdtaka  and  Knstiimhuru  mixed  with  old  treacle  ; 
or  of  simple  Arishta,  should  be  prescribed.     19. 

Management  of  the  Child:— The  baby 

being  wrapped  up  in  silk  should  be  laid  on  a  bed  covered 
with  a  silken  sheet  ;  it  should  be  fanned  with  the 
branches  of  a  Pilu,  Nimba,  Vadari,  or  Parushaka  tree. 
A  (thin^i  pad  (Pichu)  soaked  in  oil  should  be  constantly 
kept  on  the  head  of  the  child,  and  its  body  should  be 
fumigated  with  the  fumes  of  drugs  (^,^.,  Vac  ha,  mustard, 
etc.)  potent  enough  to  keep  off  the  (evil)  influences  of 
demons  and  evil  spirits.  The  same  drugs  should  be  tied 
round  the  neck,  hands,  legs  and  head  of  the  infant  and 
the  floor  of  the  lying-in  room  should  be  kept  strewn 
over  with  pounded  sesamum,  mustard,  linseed  [Atasi).  A 
fire  should  also  be  kept  kindled  in  the  chamber.  Measures 
laid  down  in  the  chapter  on  the  nursing  of  an  Ulcer- 
patient  (chapter  IX.  Sutra.)  should  be  observed  in  the 
present  case  as  well.     20. 

Then  on  the  tenth  day  of  its  birth  the  parents  having 
performed  the  necessary  rites  of  benediction  and  cele- 
brated the  occasion  with  suitable  festivities,  shall  give 
the  child  a  name  of  their  own  choice  or  one  determined 
by  its  natal  a^trism,  etc.     21. 

Lactation  and  selection  of  a  wet- 
nurse  :  -For  the  healthy  gro  vth  of  the  child  a  wet- 
nurse  should  be  selected  from  among  the  matrons  of 
its  own  caste  (Varna\    and    possessed    of  the   following 

29 


226  THE  SUSHRUTA   SAMHITA.  [Chap.  X. 

necessary  qualifications.  She  should  be  of  middle 
stature,  neither  too  old  nor  too  young  (middle-aged), 
of  sound  health,  of  good  character  (not  irascible  or  easily 
excitable),  not  fickle,  ungreedy,  neither  too  thin  nor  too 
corpulent,  with  lips  unprotruded,  and  with  healthy  and 
pure  milk  in  her  breasts  which  should  neither  be  too 
much  pendulent  nor  drawn  up.  It  should  be  carefully 
observed  that  her  skin  is  healthy  and  unmarked  by  any 
moles  or  stains,  she  being  free  from  any  sort  of  crime 
(such  as  gambling,  day-sleep,  debauchery,  etc.).  She 
should  be  of  an  affectionate  heart,  and  with  all  her 
children  living. 

She  should  be  of  respectable  parentage  and  conse- 
quently possessed  of  many  good  qualities,  with  an  exu- 
berance of  milk  in  her  breasts,  and  not  in  the  habit  of 
doing  anything  that  degrades  woman  in  life.  A  "Syama ' 
girl  possessed  of  the  aforesaid  qualities  makes  a  good 
wet-nurse.  A  child  nursed  at  the  breast  of  a  woman 
with  upturned  or  unprominent  nipples  is  apt  to  be 
deformed  (Karala)  in  features,  while  extremely  pendu- 
lous (large  and  flabby)  breasts  may  suffocate  the  child 
by  covering  its  mouth  and  nostrils.  Having  chosen  a 
wet-nurse  of  the  commendable  type,  the  child  with  its 
head  well-washed  should,  on  an  auspicious  day,  be  laid 
on  her  lap  wrapped  in  a  clean  and  untorn  linen.  The 
face  of  the  child  should  be  turned  towards  the  north, 
while  the  nurse  should  look  to  the  east  at  the  time. 
Then,  after  first  having  a  small  quantity  of  the  milk 
pressed  out  and  the  breast  washed  and  consecrated  with 
the  following  Mantras  (incantations)  the  child  should  be 
made  to  suck  her  right  breast.     22. 

Metrical  Texts  :— ''O,  thou  beautiful  damsel, 
may  the  four  oceans  of  the  earth  contribute  to  the 
secretion  of  mjlk  in  thy  breasts  for  the   purpose    of  in^-: 


Chap.  X,]  SARtRA  STHAKAM.  227 

proving  the  bodily  strength  of  the  child.  O,  thou  with 
a  beautiful  face,  may  the  child,  reared  on  your  milk, 
attain  a  long  life,  like  the  gods  made  immortal  with 
drinks  of  ambrosia".     22. 

A  child  nursed  at  the  breast  of  any  and  every 
woman  for  want  of  a  nurse  of  the  commendable  type, 
may  fall  an  easy  prey  to  disease,  owing  to  the  fact  of  the 
promiscuous  nature  of  the  milk  proving  incongenial  to 
its  physical  temperament.  The  milk  of  a  nurse  not 
being  pressed  out  and  spelled  off  at  the  outset  may 
produce  cough,  difficulty  of  breathing,  or  vomiting  of 
the  child,  owing  to  the  sudden  rush  of  the  accumulated 
milk  into  its  throat  choking  up  the  channels.  Hence 
a  child  should  not  be  allowed  to  suck  in  such  milk.     23. 

The  loss  or  suppression  of  the  milk  in  the  breasts  of 
a  woman  is  usually  due  to  anger,  grief,  and  the  absence 
of  natural  affection  for  her  child,  etc.  For  the  purpose  of 
establishing  a  flow  in  her  breast,  her  equanimity  should 
be  first  restored,  and  diets  consisting  of  Sdli-rice,  barley, 
wheat,  Shashtika,  meat-soup,  wine  (Surd\  Souviraka, 
sesamum-paste,  garlic,  fish,  Kas'eruka,  S'ringdtaka,  lotus- 
stalk,  Viddri-kandi,  Madhuka  flower,  S'atdzari,  Nalikd^ 
Aldvu,  and  Kdla-S'dka,  etc..  should  be  prescribed.     24. 

Examination,  etc.,  of  milk  :— The  breast- 
milk  of  a  nurse  or  a  mother  should  be  tested  by  casting 
it  in  water.  The  milk  which  is  thin,  cold,  clear,  and 
tinged  like  the  hue  of  a  conch-shell,  is  found  to  be 
easily  miscible  with  water,  does  not  give  rise  to 
froths  and  shreds,  and  neither  floats  nor  sinks  in  water, 
should  be  regarded  as  pure  and  healthy.  A  child  fed 
on  such  milk  is  sure  to  thrive  and  gain  in  strentgh  and 
health.  A  child  should  not  be  allowed  to  take  the 
breast  of  a  hungry,  aggrieved,  fatigued,  too  thin,  too 
corpulent,  fevered,  or  a  pregnant  woman,  nor   of  one   in 


■22S  THE  SUSHRUTA  SAMHITA  .  [Chap.  X. 

whom  the  assimilated  food  is  followed  by  an  acid  reac- 
tion, or  of  one  who  is  fond  of  incongenial  and  unhealthy 
dietary,  or  whose  fundamental  principles  are  vitiated. 
A  child  should  not  be  given  the  breast  until  an  adminis- 
tered medicine  is  assimilated  in  its  organism,  lest  this 
should  give  rise  to  a  violent  aggravation  of  the  pharmaco- 
logical action  of  the  medicine,  as  well  as  of  the  deranged 
Doshas  (Vdyu,  Pitta,  etc.), and  the  refuse  matters  (Malas) 
of  its  body.     25. 

IVIemorable  Verses:— The   Doshas  (Vayu, 

Pitta  and  Kapha)  of  a  wet-nurse  are  aggravated  by 
ingestion  of  indigestible  or  incompatible  food,  or  of  those 
articles  which  tend  to  derange  the  Doshas  of  the  body, 
and  hence  her  milk  may  be  vitiated.  A  child,  fed  on  the 
vitiated  milk  of  a  woman,  vitiated  by  the  deranged 
Doshas  owing  to  injudicious  and  intemperate  eating 
and  living,  falls  an  easy  prey  to  physical  disease,  An 
intelligent  physician  in  such  a  case  should  devise  means 
for  the  purification  of  the  milk  as  well  as  of  the  derang- 
ed Doshas  which  account  for  such  vitiation  (inasmuch  as 
the  medication  of  the  child  alone  will  not  produce  any 
satisfactory  effect).     26-27. 

Infantile  diseases  and  their  Diagno- 
sis : — -A  child  constantly  touches  its  diseased  part  or 
organ  and  cries  for  the  least  touch  (by  another  of  that 
part  of  its  body).  If  the  seat  of  disease  be  its  head,  the 
child  cannot  raise  nor  move  that  organ  and  remains  with 
its  eyes  closely  shut.  A  disease  seated  in  its  bladder 
gives  rise  to  retention  of  urine,  thirst,  pain  and  occa- 
sional fainting  fits.  A  retention  of  urine  and  stool, 
discolouring  of  complexion,  vomiting,  distention  of  the 
abdomen,  and  gurgling  in  the  intestines  indicate  the 
seat  of  the  disease  to  be  its  Koshtha  (colon).  A 
constant  crying  (and  the  child's  refusal  to   be   consoled) 


Chap.  X.]  SARIRA  STHANAM.  229 

would  signify  that  the   diseased    principle   (morbiferous 
diathesis)  extends  all  through  its  organism.     28. 

Treatment  of  Infants  :— Medicines  laid 
down  under  the  head  of  a  particular  disease  should  like- 
wise be  prescribed  in  the  case  of  its  appearance  in  a 
child  or  an  infant  ;  but  then  only  the  remedies  of  mild 
potency  and  those  which  do  not  tend  to  disintegrate  the 
bodily  fat  and  Kapha  should  be  given  in  adequate 
doses  (according  to  age,  etc.)  as  mentioned  here- 
after and  administered  through  the  vehicle  of  milk  and 
clarified  butter,  to  a  child  living  on  milk  alone,  while  the 
nurse  also  is  to  take  the  same  medicines  as  well  *  In 
the  case  of  a  child  fed  both  on  milk  and  (boiled)  rice 
{KshirdnnddaX .Q.,  living  on  both  solid  an  d  liquid  food)  the 
medicine  should  be  administered  both  to  the  child  and 
its  wet-nurse.  In  the  case  of  a  child  living  on  solid  food 
only,  decoctions  (Kashdya)  etc.  should  be  given  to  the 
child  and  not  to  the  nurse.  Medicines  to  the  quantity  of 
a  small  pinchful  may  be  prescribed  for  a  suckling  who 
has  completed  its  first  month  of  life.  Kalkas  (medicated 
pastes)  should  be  given  to  a  child  fed  on  both  milk  and 
rice  to  the  size  of  a  stone  of  a  plum-fruit  (Kola),  and  the 
dose  for  a  child  fed  on  rice  (solid  food)  only  being  to 
the  size  of  a  plum  (Kola).t     29. 

*  Milk  and  clarified  butter  being  congenial  to  the  constitution  of 
infants  should  be  used  as  vehicles  for  drugs  in  their  cases  but,  these  are 
not  necessary  in  the  case  of  the  nurse. 

t  According  to  several  other  authorities,  the  dosage  in  the  case  of 
children  is  to  be  regulated  as  follows  : — 

In  the  case  of  a  child,  one  month  old,  drugs  should  be  given  in  the  form 
of  an  electuary  through  the  vehicle  of  milk,  honey,  syrup,  clarified  butter, 
etc,— the  dose  being  one  Rati  (about  two  grains)  at  first,  and  gradually 
increased  by  a  Rati  a  month,  till  it  completes  one  year.  After  this  time  the 
dose  is  to  be  one  Masha  (about  twenty  grains)  for  each  year  of  age  till 
he  is  fifteen. 

This  dosage,  however,  does  not  apply  in  the  present  age.— Ed. 


230  THE   SUSHRUtA  SAMHITA.  tChap.  X. 

Metrical  Texts  :— in  the  case  of  any  disease 
of  a  child  nursed  at  the  breast,  the  breasts  of  the  nurse 
should  be  plastered  with  the  pastes  of  drugs  recommended 
by  physicians  for  the  particular  malady  (instead  of 
giving  the  drugs  to  the  child),  and  the  child  made  to 
suck  the  same.  The  use  of  clarified  butter  is  not  bene- 
ficial to  a  child  on  the  first  day  of  an  attack  of  Vata- 
jvara  (fever  due  to  the  derangement  of  the  bodily  Vayu), 
within  the  first  two  days  of  an  attack  of  Pittaja  fever, 
and  within  the  first  three  days  of  that  of  Kaphaja  fever. 
But  the  use  of  clarified  butter  may  be  prescribed  for 
an  infant  fed  on  milk  and  boiled  rice,  or  on  boiled  rice 
alone,  according  to  requirements.     30-3  f. 

In  case  of  fever  a  child  should  be  given  no  suck  at 
all,  lest  the  symptoms  of  thirst  might  develop.  Pur- 
gatives, Vastis,  or  emetics  are  forbidden  in  the  disease 
of  children,  unless  the  disease  threatens  to  take  a  fatal 
course.     32. 

If  the  local  Vayu  aggravated  by  the  waste  of  brain- 
materials  (Mastulunga),  bends  down  the  palate  bone  of  a 
child  attended  with  an  excessive  thirst  and  agony, 
clarified  butter  boiled  with  (the  decoction  and  Kalka  of) 
the  drugs  of  the  Madhura  Gana,  should  be  used  both 
internally  and  externally,  and  the  patient  should  as  well 
be  treated  with  spray  of  cold  water  (to  stimulate  him). 
The  disease  in  which  the  navel  of  a  child  becomes 
swollen  and  painful,  is  called  Tundi.  It  should  be 
remedied  by  applying  fomentations,  medicated  oils, 
Upanahas,  etc.,  possessed  of  the  virtue  of  subduing  the 
Vayu.  A  suppuration  of  the  anal  region  (Guda-pSika)  of 
a  child  should  be  treated  with  Pittaghna  (Pitta-destroy- 
ing) measures  and  medicines.  Rasanjana  used  inter- 
nally and  externally  (as  an  unguent)  proves  very  efifica- 
cious  in  these  cases.     33-35. 


Chap.  X.']  SARIRA  STHANAM.  23I 

Infantile  Elixirs  :— Clarified  butter  cooked 
with  (the  decoction  and  Kalka  of)  white  mustard  seeds, 
Vachd,  Mdnsi,  Payasyd,  Apdmdrga,  S'atdvari,  Sdrivd, 
Brdhmi,  Pippali^  Hai^idrd^  K^ishtJLa  and  Samdhava  salt 
should  be  given  to  an  infant  fed  exclusively  on  milk. 
Clarified  butter  prepared  with  (the  docoction  and  Kalka 
of)  Madhika  (Yashtimadhu),  Vacha,  Chitraka,  Pippali 
and  Triphald  should  be  given  to  an  infant  fed  both  on 
milk  and  (boiled)  rice  (solid  and  liquid  food).  Clarified 
butter  boiled  with  (the  decoction  and  Kalka  ofj  Das'amula, 
milk,  Tagara,  Bhadraddru,  MaricJia,  honey,  Vidanga, 
Drdkshd  and  the  two  sorts  of  Brdhmis  should  be  given 
to  an  infant  fed  on  (boiled)  rice  (solid  food)  By  these  the 
health,  strength,  intellect  and  longivity  of  the  child 
is  improved.      36-37. 

A  child  should  be  so  handled  or  lifted  as  not  to 
cause  any  discomfort.  A  baby  should  not  be  scolded, 
nor  suddenly  roused  up  (from  sleep),  lest  it  might  get 
awfully  frightened.  It  should  not  be  suddenly  drawn 
up  nor  suddenly  laid  down,  lest  this  should  result  in  the 
derangement  of  its  bodily  Vdyu.  An  attempt  to  seat 
it  (before  it  has  learnt  to  sit  steadily),  may  lead  to 
haunch-back  (Kyphosis).  Lovingly  should  a  child 
be  fondled  and  amused  with  toys  and  play-things. 
A  child  unruffled  by  any  of  the  above  ways  becomes 
healthy,  cheerful  and  intelligent  as  it  grows  older.  An 
infant  should  be  guarded  against  any  exposure  to  the 
rains,  the  sun, or  the  glare  of  lightning.  He  should  not 
be  placed  uuder  a  tree  or  a  creeper,  in  low  lands, 
and  in  lonely  houses  or  in  their  shades  (caves) ;  and  it 
should  be  protected  from  the  malignant  influences  of 
evil  stars  and  occult  powers.     38. 

IVIctrical  Texts  :— A  child  should  not    be    left 
(alone)  in  an  unclean  and  unholy  place,  nor  under  the  sky 


232  THE   SUSHRUTA  SAMHITA.  [Chap.  X. 

(uncovered  place),  nor  over  an  undulating  ground,  nor 
should  it  be  exposed  to  heat,  storm,  rain,  dust,  smoke  and 
water.  Milk  is  congenial  to  the  organism  of  a  chiid, 
i  e.,  it  is  its  proper  food  Hence  in  the  absence  of 
sufficient  breast-milk,  the  child  should  be  given  the  milk 
of  a  cow  or  of  a  she-goat  in  adequate  quantities.     39. 

In  the  sixth  month  of  its  birth  the  child  should  be 
fed  on  light  and  wholesome  boiled  rice.  A  child  should 
always  be  kept  in  an  inner  apartment  of  the  house, 
and  religious  rites  should  be  performed  on  its  behalf  for 
the  propitiation  of  evil  deities,  and  it  should  be  carefully 
guarded  against  the  influences  of  evil  stars.     40. 

Symptoms  when  a  malignant  star, 

etc.,  strikes  :— The  child  looks  frightened  and 
agitated,  cries,  becomes  unconscious  at  times,  wounds 
himself  or  its  nurse  with  its  teeth  and  finger-nails, 
gnashes  its  teeth,  crooks,  yawns,  or  moves  its  eye-brows 
with  upturned  eyes,  vomits  frothy  matter,  bites  its  lips, 
becomes  cross,  passes  loose  stool  mixed  with  shreds 
of  mucus,  cries  in  an  agonised  voice,  becomes  dull  in 
complexion,  becomes  weak,  does  not  sleep  in  the  night, 
does  not  suck  the  breast  as  before,  or  emits  a  fishy, 
bug-like  or  mole-like  smell  from  its  body — these  are 
the  general  symptoms  exhibited  by  a  child  under  the 
influence  of  a  malignant  star  or  planet  which  will  be 
specifically  described  later  on  in  the  Uttara-Tantra      41. 

Education  and  IVIarriage  :  -The  educa- 
tion of  a  child  should  be  commenced  at  a  suitable  age 
and  with  subjects  proper  to  the  particular  social  Varna 
or  order  it  belongs  to.  On  attaining  the  twenty-fifth  year 
he  should  marry  a  girl  of  twelve.  A  conformity  to 
these  rules,  is  sure  to  crown  him  with  health,  satisfaction, 
progeny  and  a  capacity  for  fully  discharging  the  religious 
rites  and  paying  off  his  parental  debts.    42.. 


Chap.  X.J  SARiRA  StHANAM.  2^$ 

IVIetrical  Texts  :— An  offspring  of  a  girl  below 
the  age  of  sixteen  by  a  man  below  twentpjr-five  is 
usually  found  to  die  in  the  womb.  Such  a  child,  in  the 
event  of  its  being  born  alive,  dies  a  premature  death 
or  else  becomes  weak  in  organs  (I ndriyas).  Hence  agirl 
of  extremely  tender  age  should  not  be  fecundated  at  all. 
An  extremely  old  woman,  or  one  suffering  from  a 
chronic  affection  (of  the  generative  organ),  or  afflicted 
with  any  other  disease,  should  not  be  likewise  impreg- 
nated. A  man  with  similar  disabilities  should  be  held 
likewise  unfit.     40-44. 

A  foetus,  on  the  point  of  being  miscarried  on  account 
of  the  above-mentioned  causes,  produces  pain  in  the 
uterus,  bladder,  waist  (Kati),  and  the  inguinal  regions 
(Vamkshana)  and  bleeding.  In  such  a  case,  the  patient 
should  be  treated  with  cold  baths,  sprays  of  cold  water 
and  medicated  plaster  (Pradeha)  &c.,  at  the  time,  and 
milk  *  boiled  with  drugs  constituting  the  Jivaniya 
group,  should  be  given  to  her  for  drink.  In  case  of 
unusual  movements  of  the  foetus  in  the  womb,  the 
enciente  should  be  given  a  drink  of  milk  boiled  with  the 
drugs  of  Utpalddi  Gana^^QX  soothing  and  making  It 
steady  in  its  place.  45. 

A  foetus  being  displaced  from  its  normal  position 
produces  the  following  symptoms,  viz  ,  pain  or  spasms 
in  the  back  and  the  sides  (Pars'va),  burning  sensation, 
excessive  discharge  of  blood  and  retention  of  urine  and 
fceces  A  foetus  changing  place  or  shifting  from  one 
place  to  another,  swells  up  the  abdomen  (Koshtha). 
Cooling  and  soothing  measures  should  be  adopted  in 
such  cases.  46. 

*  Jivaniya  drugs  two  Tolas,  milk  sixteen  Tolas  and  water  sixty-four 
Tolas,  to  be  boiled  and  reduced  to  sixteen  Tolas,  ?'.(?.,  to  wtight  of  the 
milk, 

30 


234  THE  SUSHRUTA  SAMHITA.  [Chap.  X. 

Medical   Treatment :— in  a  case  of  pain 

under  the  circumstances,  the  enciente  should  be  made 
to  drink  a  potion  consisting  of  milk  boiled  with  Mahd- 
sdha,  Kshudrasahdf  Madhuka  flower,  S'vadanstrd  and 
Kantakdri,  mixed  with  sugar  and  honey.  In  the  case  of 
retention  of  urine,  the  patient  should  be  made  to 
drink  a  potion  of  milk  boiled  with  drugs  known  as  the 
Ddrvddi  Gana  (mixed  with  sugar  and  honey).  In  the 
case  of  A'naha  (retention  of  stool  attended  with  disten- 
tion of  the  abdomen),  a  potion  consisting  of  milk 
boiled  with  asafetida,  Sauvarchala  salt,  garlic  and  Vacha 
(mixed  with  honey  and  sugar)  should  be  given.  In 
cases  of  excessive  bleeding,  linctus  made  of  the  powdered 
chamber  of  a  Koshthdgarika  insect  *  ,  Samangd^ 
Dhdtaki  flowers,  Navamdlikd,  Gairika,  resin  and  Rasdn- 
fana,  or  of  as  many  of  them  as  would  be  available, 
mixed  with  honey,  should  be  licked.  In  the  alternative, 
the  bark  and  sprouts  of  the  drugs  known  as  the  Nya- 
grodhddi  Gana  mixed  with  boiled  milk  should  be 
administered,  or  a  Kalka  of  the  drugs  of  the  Utpaladi 
group  mixed  with  boiled  milk  should  be  used,  or  a 
Kalka  of  S'aluka,  S'ringataka  and  Kas'eru  mixed  with 
boiled  milk  should  be  given.  As  a  further  alternative,  the 
enciente  may  be  made  to  eat  cakes  made  of  powdered 
Sali  rice  with  the  decoction  of  Udumbara  fruit  and 
Audaka-kanda,  mixed  with  honey  and  sugar.  A  piece 
of  linen  or  a  plug  soaked  in  the  expressed  juice  of  the 
drugs  of  the  Nyagrodhadi  group  should  be  inserted 
into  the  passage  of  the  vagina.     47. 

In  a  case  of  pain  unattended  with  bleeding,  the 
enciente  should  be  made  to  drink  a  potion  composed  of 
milk-boiled  with  J/<^<//////^^(Yashtimadhu),  Devaddm  and 

*  There  is   a    kind    of  insect   which   makes  its  chamber   with   earth 
generally  under  the  ceiling  or  on  the  walls.     This  earth  should  be  used. 


Chap.  X.]  SARIRA  STHANAM.  235 

Payasyd  ;  or  with  As'mantaka^  Satdvari  and  Payasyd  ; 
or  with  the  drugs  of  the  group  of  V iddrigandhddi  Gana  ; 
or  with  Vrihati,  Kantakdri,  Utpala,  S'atdvari,  Sdrivdy 
Payasyd  and  Madhuka  (Yashtimadhu).  These  remedies 
speedily  applied  tend  to  alleviate  the  pain  and  make  the 
foetus  steady  in  the  womb.     48. 

After  the  foetus  has  been  steadied  by  the  aforesaid 
mesaures,  a  diet  consisting  of  (boiled  rice  and)  cow's 
milk,  boiled  with  the  dried  tender  fruits  of  Udmnvara, 
should  be  prescribed  for  the  patient.  In  the  event  of 
miscarriage,  the  patient  should  be  made  to  drink  a 
Yavigu  (gruel)  of  the  Udddlaka  rice,  &c.,  cooked  with 
the  decoction  of  the  Pachaniya  group  (Pippalyddi)  and 
devoid  of  all  saline  and  fatty  matter,  for  a  number  of 
days  corresponding  to  that  of  the  month  of  gestation. 
Old  treacle  mixed  with  the  powdered  drugs  of  the 
Dipaniya  group  (Pancha-kola),  or  simply  some  Arishta 
(Abhay^rishta,  etc.),  should  be  given,  in  the  event 
of  there  being  pain  in  the  pelvis,  bladder  and 
abdomen.     49. 

The  internal  ducts  and  channels  (Srotas)  stuffed  with 
aggravated  Vdyu  lead  to  the  weakening  (Laya)  of  the 
foetus  and,  if  the  state  continues,  it  leads  even  to  its 
death.  Hence  the  case  should  be  treated  with  mild 
anointing  measures,  etc.,  (Sneha-karma,  etc.,)  and  gruels 
made  of  the  flesh  of  the  birds  of  the  Utkros'a  species  and 
mixed  with  a  sufficient  quantity  of  clarified  butter,  should 
be  given  to  her.  As  an  alternative,  Kulmasha  *  boiled 
with  .Masha,  sesamum  and  pieces  of  dried  (tender) 
Vilva  fruit  should  be  given  her,  after  which  she  should 
be  made  to  drink,  for  a  week,  honey  and  Mdddhvika  (a 
kind  of  weak  wine).     At  the  non-delivery  of  the  child 

*  **Kulmdsha"  may  mean  either  Kulattha  pulse  or   half  boiled   wheat, 
barley,  etc. 


236  THE  SUSHRUTA  SAMHITA.  [Chap.  X. 

•even  after  the  lapse  of  the  full  term  of  gestation,  the 
eaciente  should  be  made  to  thrash  corn  with  a  pestle  in 
9,;n  Udukhala  or  mortar  (husking  apparatus)  or  should  he 
il9,de  -to  sit  or  move  (on  legs  or  by  conveyance),  on  an 
juneven  ground.     50. 

Atrophy  of  a  foetus  in  the  womb  should  be  ascribed 
to  the  action  of  the  deranged  Vdyu.  This  is  detected 
by  the  comparatively  lesser  fulness  of  the  abdomen 
of  the  enciente  and  slow  movement  of  the  foetus  in 
tiie  womb.  In  such  a  case,  the  enciente  should  be 
treated  with  milk,  with  Jhe  Vrimhaniya  (of  restorative 
a.^d  construQtive  properties)  drugs,  and  with  meat- 
soup.*     51. 

A  combination  of  ovum  and  semen  affected  by  the 
deranged  Vayu  in  the  womb,  may  not  give  rise  to  a 
SjUccessful  fecundation  (living  impregnated  matter),  but 
leads  to  a  distention  of  the  abdomen  (as  in  pregnancy), 
which  again,  at  any  time,  may  disappear  of  itself.  And 
this  is  ascribed  by  the  ignorant  to  the  malignant 
influence  of  Naigamesha  (spirits).  Such  an  impregnated 
matter,  sometimes  lying  concealed  in  the  uterus,  is 
called  Nagodara,  which  should  be  treated  with  the 
remedies  laid  down  under  the  head  of  Lina-Garbha 
(weak  foetus).     52. 

Now  we  shall  discourse  on  the  management  of 
pregnancy  according  to  the  months  (period)  of  gestation. 
Metrical  Texts:— The  following  receipes,  such  as, 
(i)  Madhuka  (Yashtimadhu),  S'dkavija,  Payasyi,  and 
Devadiru  ;  (2)  As'mantaka,  black  sesamum,  pippali, 
Manjishth^,  Tcimra-valli  and  Satcivari  ;  (3)  Vrikshddani, 
Payasya,  Latd.  (Durvi),  Utpala  and  Sdriv^  ;  (4)  Ananta, 
Siriya,  RdsnA,  Padma,    and    Madhuka  (Yashtimadhu)  ; 

*  The    panicle    "chA"    in  the    text   signifies   the   use   of    any   other 
consiructive  tonic. 


Chap.  X.]  SARIRA  STHANAM.  237 

(5)  Vrihati,  Kantakdri,  Kas'mari,  sprouts  (Sunga)  and 
barks  of  milk-exuding  trees  (as,  Vata,  etc.),  and  clariiied 
butteri*  ;  (6)  Pris'ni-parni,  Vald,  Sigru,  S'vadanshtra 
and  Madhuparnika  ;  and  (7)  S'ring'taka,  Visa  (stalks 
of  lotus),  Draksha,  Kasaru,  Madhuka  (Yashtimadhu), 
and  sugar  ;  should  successively  be  given  with  milk*  to 
an  enciente,  from  the  first  to  the  seventh  month  of  her 
gestation,  in  the  case  of  a  threatened  miscarraige  or 
abortion.     53. 

An  enciente  should  be  made  to  drink  milk  boiled 
with  the  roots  of  Kapittha,  Vrihati,  Vilva,  Patola, 
Ikshu  and  Kantakari,  (in  case  of  impending  or 
threatened  miscarraige)  in  the  eighth  month  of  her 
pregnancy.  In  the  ninth  month  (and  under  similai* 
conditions),  the  potion  should  be  made  up  of  Madhuka 
(Yashtimadhu),  Ananta-mula,  Payasha  and  Sariva.  In 
the  tenth  month  (and  under  similar  conditions),  a  potion 
consisting  of  milk  boiled  with  Sunthi  and  Payasyd 
is  beneficial, or,  in  the  alternative,  may  be  given  a  potion 
made  up  of  milk  with  Sunthi,  Madhuka  (Liquorice,  and 
Devadaru.  The  severe  pain  would  vanish  and  the 
fcetus  would  continue  to  develop  safely  in  the  womb, 
under  the  aforesaid  mode  of  treatment.     54-57' 

A  child  born  of  a  woman,  who  had  remained  sterile 
(not-conceived)  for  a  period  of  six  years  (Niviitta- 
prasava)*  after  a  previous  child-birth,  becomes  a  short- 
lived one.     58. 

*  ChakradaUa  reads  "Visam"  (stalks  of  lotus)  instead  of  "Ghritara" 
(clarified  butter). 

t  If  a  conception  does  not  occur  in  a  woman  for  a  period  of  more  than 
five  years  a''ter  a  child-birth,  she  is  called  Nivritta-prasaVSl. 

*  Sivadasa  also  says  that  powders  of  these  drugs  should  be  given 
with  boiled  milk,  but  he  adds  that  some  authorities  recommend  theaQ 
drugs  to  be  boiled  in  milk  according  to  Kshira-paka-vidhi. 


238  THE  SUSHRUTA  SAMHITA.  [Chap.  X. 

Application  of  mild  emetic  medicines,  (though  for- 
bidden in  the  case  of  a  pregnant  woman),  may  be 
resorted  to,  in  the  case  of  a  fatal  disease,  (even  in  that 
stage).  A  diet  consisting  of  sweet  and  acid  things  should 
be  prescribed  for  her,  so  as  to  bring  the  deranged 
Doshas  to  the  normal  state  ;  mild  Sams'amaniya 
(soothing  and  pacifying)  medicines  should  be  applied 
and  food  and  drink  consisting  of  articles  mild  in  their 
potency,  predominently  sweet-tasting  and  not  injurious 
to  the  foetus,  should  be  advised  and  mild  (external) 
measures  not  baneful  to  the  foetus  should  be  resorted 
to,  according  to  the  requirements  of  the  case.     59. 

IVIemorable  Verses  :— The  growth,  memory, 

strength  and  intellect  of  a  child  are  improved  by  the 
use  of  the  four  following  medicinal  compounds,  used  as 
linctus  (Prds'a),  viz.,  (i)  well-powdered  gold,  Kushtha, 
honey,  clarified  butter  and  Vacha  ;  (2)  Matsyakshaka* 
(Brdhmi),  Sankha-puspi,  powdered  gold,  clarified  butter 
and  honey  ;  (3)  Arkapuspi,  honey,  clarified  butter 
powdered  gold  and  Vacha  ;  and  (4)  powdered  gold, 
Kaitaryyah  (Maha-Nimba),  white  Durba,t  clarified 
butter  and  honey.     60. 

Thus  ends  the  tenth  Chapter  of  the  S'arira  Sthanam  in  the  Sus'rula 
Samhita,  which  treats  of  the  nursing  and  management  etc.  of  pregnant 
women. 

*  Some,  however,  explain  Matsyakshaka  to  be  Dkuslura;  others  again 
say  it  is  a  kind  of  red-flowered  shrub  grown  in  the  Anupa  country. 

t  The  word  "S'veta,"  in  the  Text,  may  either  be  adjective  to 
"DurvgC"  and  mean  "white"  or  it  may  mean  white  Vacha  or  white 
Aparajita  or  white  Durv£t. 


Here  ends  the  ^arira  Sthanam. 


THE 

SUSRUTA  SAMHITA 

CHIKITSA-STHANAM. 

(Section  of  Therapeutics). 


CHAPTER  I. 

Now  we  shall  discourse  on  the  medical  treatment 
of  the  two    kinds    of  inflamed    ulcers    (Dvivraniya 

Chikitsitam).    i. 

Ulcers  may  be  grouped  under  two  heads  according 
as  they  are  Idiopathic  or  Traumatic  in  their  oiigin. 
The  first  group  includes  within  its  boundary  all  ulcers 
that  are  caused  through  the  vitiated  condition  of  the 
blood  or  the  several  deranged  conditions  of  the  Vayu, 
Pitta  and  Kapha,  or  are  due  to  their  concerted 
action  (Sannipata),  while  the  second  group  embraces 
those  which  are  caused  by  the  bites  of  men,  beasts, 
birds,  ferocious  animals,  reptiles  or  lizards,  or  by  a 
fall,  pressure  and  blow,  or  by  fire,  alkali,  poison,  or 
irritant  drugs,  or  through  injuries  inflicted  by  pointed 
wood,  skeletal  bones*  horns,  discus,  arrows,  axes, 
tridents,  or  Kuntas  (a  kind  of  shovel\  or  such  other 
weapons.  Although  both  th3se  classes  of  ulcers  possess 
many  features  in  common,  they  have  been  grouped 
under  two  distinct  heads  on  account  of  the  diversity  of 
their  origin,  the  difference  in  remedial  measures  to  be 
adopted  in  their  treatment,   and    the    variation    in    their 

*     Fragments  of  broken  pottery.^ — Dallana. 


240  THE  SUSHRUTA  SAMHITA.  [Chap.  I, 

Strength  and  tenacity.  Hence  the  chapter  is  called 
Dvivraniya.     2. 

In  all  cases  of  traumatic  ulcers,  cooling  measures 
should  be  at  once  resorted  to,  just  after  (the  fall  or 
blow  or  stroke),  for  the  cooling  of  the  expanding  (radia- 
ting) heat  of  the  incidenta'  ulcer,  in  the  manner  laid 
down  in  respect  of  (the  pacification  of  enraged)  Pitta, 
and  a  compound  of  honey  and  clarified  butter  should  be 
applied  on  the  wounded  locality  for  the  adhesion 
(Sandhdna)  of  the  lacerated  parts,  [and  for  the  pacifica- 
tion, i.e,  restoration  to  normal  state,  of  the  local  blood 
and  Vdyu  aggravated  through  an  obstruction  of  their 
passage].  Hence  arises  the  necessity  of  making  the 
two-fold  classification  of  ulcers.  After  that  (a  week) 
a  traumatic  ulcer  should  be  treated  as  an  idiopathic 
one  (to  all  intents  and  purposes\  inasmuch  as  it  is 
found  to  be  associated  with  deranged  Vayu,  Pitta  or 
Kapha  Hence  at  that  stage  the  medical  treatment 
of  both  the  forms  of  ulcer  is  (practically)  the  same.     3. 

In  short,  ulcers  are  further  subdivided  (particularly) 
into  fifteen  groups,  according  to  the  presence  of  the 
morbific  diathesis  (deranged  Vayu,  Pitta  Kapha 
and  blood  therein),  either  severally  or  in  combi- 
nations as  described  (before)  in  the  Chapter  on  Vrana- 
Prasna  (Sutra  Sthanam.  Ch.  XXI).  Several  author- 
ities, by  adding  the  simple  uncomplicated  ulcers  (un- 
associated  with  any  of  the  morbific  principles  of  the 
deranged  Vayu,  Pitta,  &c.)  to  the  list,  hold  the  number 
of  types  to  be  sixteen.  (Practically  they  are  in- 
numerable, according  to  the  combinations  made  of  the 
deranged  Vdyu,  etc.  and  the  different  Dhaitus  of  the 
system).     4. 

Symptoms  of  ulcer  may  be  divided  into  two  kinds  viz.^ 
General  and  Specific.     Pain  is  the  general  characteristic 


Chap.  I.]  CHIKITSA  STHANAM.  24t 

(of  all  forms  of  ulcer),  while  the  symptoms,  which  are 
exhibited  in  each  case  according  to  the  virtue  of  the 
deranged  Vdyu,  Pitta,  etc,  involved  therein,  are  called  the 
Specific  ones.  A  Vrana  is  so  named  from  its  etymology 
(the  term  being  derived  from  the  root  Vrana — to  break) 
and  signifies  a  cracked  or  broken  condition  ^of  the  skin 
and  flesh  of  the  afflicted  part)  of  the  body.     5. 

The  Vataja- Ulcer  :— The  ulcer  assumes  a 
brown  or  vermilion  colour  and  exudes  a  thin,  slimy 
and  cold  secretion,  largely  attended  with  tension, 
throbbing  and  a  sort  of  pricking  and  piercing  pain  (in 
its  inside),  which  seems  as  if  being  expanded  and 
extended.  This  type  of  ulcer  does  not  extend  much 
and  is  characterised  by  a  complete  destruction  of  the 
tissue  (flesh).  The  Pittaja  ulcer  is  rapid  in  its  growth. 
It  assumes  a  bluish  yellow  colour,  exudes  a  hot  secretion 
resembling  the  washings  of  Kims'uka  flowers,  and  is 
attended  with  burning,  suppuration  and  redness,  being 
surrounded  with  eruptions  of  small  yellow-coloured 
pustules.  The  Kaphaja  ulcer  is  found  to  be  extended 
and  raised  around  its  margin  and  is  accompanied  by  an 
irresistible  itching  sensation.  It  is  thick  and  compact 
(in  its  depth),  covered  with  a  large  number  of  vessels 
and  membranous  tissues  (Sira-sndyu-jala),  grey  in 
colour,  slightly  painful,  hard  and  heavy,  and  exudes  a 
thick,  cold,  white  and  slimy  secretion.  The  Raktaja 
ulcer  (resulting  from  a  vitiated  condition  of  the  blood) 
looks  like  a  lump  of  red  coral.  It  is  often  found 
to  be  surrounded  by  black  vesicles  and  pustules  and 
to  smell  like  a  strong  alkali.  It  becomes  painful  and 
produces  a  sensation,  as  if  fumes  were  escaping  out 
(of  it).  Bleeding  (is  present)  and  the  specific  symp- 
toms of  the  Pittaja  type  are  likewise  found  to 
supervene.     6 — 9. 

31 


242  THE  SUSHRUTA  SAMHITA.  Chap.  I.] 

The  Vata-Pittaja  Type  :— An  ulcer  due  to 

the  concerted  action  of  the    deranged    Vayu   and    Pitta 
is  marked  by  a  pricking  and    burning   pain   and   a   red 
or  vermilion  colour.     A  sensation  of  fumes   arising   out 
of  it   (is  also   felt)  and    the   ulcer   exudes   a   secretion 
which  partakes  of  the  characteristic  colours  of  both   the 
deranged  Vdyu   and    Pitta.     An    itching   and   piercing 
pain  is  felt  In  the  ulcer  due  to  the    combined    action    of 
the  deranged    Vayu    and  Kapha  (Kapha- Vattaja  type), 
which   becomes    heavy    and    indurated,    constantly  dis- 
charging  a    cold,    slimy   secretion.    An  ulcer   resulting 
from  the  deranged  condition  of  the    Pitta   and    Kapha 
(Kapha-Pittaja  type)   becomes   heavy,  hot  and  yellow. 
It  is  marked  by  a  burning   sensatian  and  exudes  a  pale, 
yellow-coloured    secretion.     An    ulcer    marked   by   the 
aggravated  condition  of  the  deranged  Vayu   and    blood 
(VsLta-Raktaja  type)   is   dry  and   thin   and   is  largely 
attended      with    a   piercing    pain    and    anaesthesia.     It 
exudes  blood    or   a    vermil-coloured    secretion    and    is 
marked  by  the  combined  hues    respectively   peculiar   to 
the  deranged  Vayu  and    blood.     An    ulcer   due    to   the 
combined     action     of    the   deranged    Pitta   and   blood 
(Kakta-Pittaja    type)    is   marked   by  a   colour  which 
resembles   the   surface    cream    of    clarified    butter.     It 
smells  like  the  washing  of  fish,  is  soft,    spreading   (erysi- 
pelatous),    and    secretes   a   hot   blackish   matter.     An 
ulcer   due   to   the   combined     action    of  the   deranged 
Kapha  and  blood  (Kapha-Raktaja  type)  is  red-coloured, 
heavy,     slimy,    glossy   and   indurated.     It   is     usually 
marked   by   itching    and    exudes   a    yellowish   bloody 
secretion.     An  ulcer  due  to  the  concerted  action   of  the 
deranged  Vdyu,  Pitta   and  blood   (Va'ta-Pitta-Raktaja 
type)   is  maiked  by  a  sort   of  throbbing,  pricking   and 
burning  pain.     It  discharges  a   flow   of  thin   yellowish 


Chap.  I.j  CHIKItSA  STHANAM.  243 

blood     and     produces   a   sensation,   as   if  fumes   were 
escaping  (out  of  its  cavity).     An   ulcer  due  to   the  con- 
certed   action  of  the  deranged  Vayu,  Kapha  and   blood 
(Vaita-Sleshma-Raktaja  type)  is  usually  attended  with 
itching,  throbbing  and  tingling  sensations  and  thick,  grey, 
blood-streaked    discharge.        An    ulcer   associated  with 
the  deranged  Kapha,    Pitta,    and    blood  (Kapha-Pitta- 
Raktaja  type)  is  largely  attended  with  redness,  itching, 
suppuration  and  burning   sensation.     It   emits   a   thick, 
greyish,    bloody    secretion.     An    ulcer   marked    by   the 
concerted     action    of    the   deranged    Vayu,    Pitta    and 
Kapha   (Satanipaitika)   is   attended  with  diverse    kinds 
of  pain,   secretion,    colour,    &c.,   peculiar     to     each   of 
these  types.     An  ulcer   associated   with   the   combined 
action  of  the  deranged  Vayu,    Pitta,  Kapha    and    blood 
(Va^ta-Pitta-Kapha-Raktaja  type)  is  attended  with  a 
sensation,  as  if  it  were  being  burnt  and  lacerated.     It  is 
largely   accompanied    by   throbbing,  itchin^^    sensation, 
a  sort   of    pricking   and    burning    pain,    with  complete 
anaesthesia  in  the  locality;  redness,  suppuration,    various 
other  kinds  of  colour,  pain  and  secretion  are  its   further 
characteristics.     10 — 20. 

An  ulcer  (Vrana)  which  is  of  the  same  colour  with  the 
back  of  the  tongue,  soft,  glossy,  smooth,  painless,  well- 
shaped  and  marked  by  the  absence  of  any  kind  of 
secretion  whatsoever,  is  called  a  clean  ulcer  (Suddha- 
Vrana).    21. 

Therapeutics  :— The  medical  (and  surgical) 
treatment  of  a  Vrana  (ulcer)  admits  of  being  divided 
into  sixty  *  different  factors,  such  as,— Apatarpana 
(fasting  or  low  diet),  Alepa  (plastering),  Parisheka 
(irrigating   or    spraying),  Abhyanga  (anointing),   Sveda 

*    N.B.     Authorities,  however,  differ  in   enumerating   these  factors, 
although  every  oiae  of  them  sticks  to  the  total  number  of  sixty. 


^44  THfe  SUSHRUTA   SAMhITA.  fChap.  t. 

(fomentations,     etc.),    Vimldpana    (resolution    by   mass- 
age or  rubbing),  Upanaha  (poultice),   Pdchana   (inducing 
suppuration),  Visrdvana  (evacuating  or  draining),   Sneha 
(internal  use   of    medicated   oils,   ghrita,   etc.),  Vamana 
(emetics),  Virechana  (purgatives),    Chhedana   (excision), 
Bhedana  (opening — e.g.,  of  an  abscess),  Dirana  (bursting 
by  medicinal  applications),  Lekhana  (scraping),  Aharana 
(extraction^  Eshana  (probing),  Vyadhana  (puncturing— 
opening  a  vein),  Vidrdvana  (inducing  discharge),  Sivana 
(suturing),    Sandhana     (helping   re-union   or   adhesion), 
Pidana  (pressing),  Sonitasthdpana   (arrest   of  bleeding), 
Nirvdpana     (cooling    application),     Utkarikd     (massive 
poultices),    Kashaya   (washing   with   decoctions),   Varti 
(lint     or    plug),    Kalka   (paste),   Ghrita   (application    of 
medicated     clarified      butter),     Taila     (application     of 
medicated  oil\  Rasa-kriya  (application  of  drug-extracts), 
Avachurnana  (dusting  with   medicinal  powders),  Vrana- 
Dhupana  (fumigation  of  an  ulcer),  Utsddana    (raising  of 
the  margins  or  bed  of  an  ulcer),  Avasddana   (destruction 
of   exuberant    granulation),    Mridu-Karma  (softening), 
Daruna-Karma  (hardening  of  soft  parts),  Kshdra-Karma 
(application   of    caustics),    Agni-Karma   (cauterization), 
Krishna-Karma     (blackening),    Pandu-Karma  (making 
yellow-coloured   cicatrices),    Pratisarana  (rubbing    with 
medicinal  powders),  Roma-sanjanana  (growing  of  hairs), 
Lomdpaharana  (epilation),  Vasti-karma  (application    of 
enemas),   Uttara-Vasti-karma     (urethral      and     vaginal 
injections\  Vandha  (bandaging),  Patradana  (application 
of  certain  leaves — vide  Infra),    Krimighna   (Vermifugal 
measures\   Vrimhana  (application  of  restorative  tonics), 
Vishaghna   (disinfectant  or  anti-poisonous  applications), 
Siro-virechana      (errhines),      Nasya     (snuff),      Kavala- 
dharana  (holding  in  the  mouth  of  certain  drug-masses  for 
diseases  of  the  oral  cavity  or  gargling),  Dhuma  (smoking 


Chap.  1.]  CHIKLITSA  STHANAM.  245 

or  vapouring),  Madhu-sarpih  (honey  and  clarified  butter), 
Yantra  (mechanical  contrivances,  e  g.,  pulleys,  &c.), 
Ahara  (diet)  and  Raksha-Vidhana  (protection  from 
the   influence  of   malicious  spirits).     22. 

Of  these,  Kashaya,  Varti,  Kalka,  Ghrita,  Taila,  Rasa- 
kriya  and  Avachurnana  are  the  measures  for  the  cleansing 
(Sodhana)  of  an  ulcer  and  for  helping  its  granulation 
(Ropana).  The  eight  acts  (from  Chhedana  to  Sivana) 
are  surgical  operations.  We  have  already  spoken  of 
such  acts  as  Sonitasthapana,  Kshara-karma,  Agni- 
karma,  Yantra,  Ahdra,  Raksha-vidhana  and  Vandha- 
Vidhana  (in  the  Sutra-sth^na).  Later  on,  we  shall 
discourse  on  Sneha,  Sveda,  Vamana,  Virechana,  Vasti, 
Uttara-vasti,  Siro-virechana,  Nasya,  Dhuma,  and  Kavala- 
dharana.  Of  the  remaining  measures  we  shall  speak 
in  the  present  chapter.     23. 

There  are  six  kinds  of  swellings  (Sophas),  as  described 
before,  and  the  following  eleven  measures.,  commencing 
with  Apatarpana  and  ending  in  Virechana,  should  be 
regarded  as  their  cure.  These  are  the  proper  remedies  for 
a  swelling  and  do  not  (cease  to  be  efficacious  in,  nor)  prove 
hostile  to  cases  of  swelling  which  are  transformed  into 
ulcers.  The  other  measures  should  be  deemed  as 
remedial  to  ulcers  but  Apatarpana  is  the  first, 
general  and  principal  remedy  in  all  types  of  swellings 
(Sophas).  24. 

Memorable  Verses --—Apatarpana  (fasting) 

should  be  prescribed  in  the  case  of  a  patient,  full  of 
enraged  Doshas,  as  well  as,  in  one  having  his  organic 
principles  (Dhatus)  and  refuse  matters  (Malas)  of  the 
system,  deranged  by  them,  for  the  purpose  of  bringing 
them  to  their  normal  condition,  with  a  regard  both 
to  their  nature  and  to  the  strength,  age,  &c.,  of  the 
patient.     Persons   afflicted    with   diseases   which   result 


246  THE  SUSHRUTA'SAMMITA.  tChap.  t. 

from  the  up-coursing  of  the'deranged  Vayu(Urdhva-vata) 
such  as  cough,  asthma,  &c.,  or  with  thirst,  hunger, 
dryness  of  the  mouth  and  fatigue,  as  well  as  old  men, 
infants,  weak  persons,  men  of  timid  dispositions  and 
pregnant  vvom^n  should' never  fast.  A  swelling  and  an 
extremely  painful  ulcer  should  be  respectively  treated 
with  a  proper  medicated  plaster  at  the  very  outset.  The 
pain  in  such  a  case  will  yield  to  the  medicinal  plaster 
as  a  blazing  room  or  house  is  readily  extinguished  by 
means  of  steady  watering.  Such  plasters  not  only  give 
comfort  to  the  patient  (by  removing  the  pain  and  leading 
to  the  absorption  of  the  swelling),  but  heaves  up  the  bed 
of  the  sore  or  the  ulcer  and  contributes  to  its  speedy 
purification  and  healing  up  (granulation).     25—28. 

In  the  case  of  a  swelling  brought  on  by  the  deranged 
Vayu,  the  affected  part  should  be  washed  or  sprinkled 
(Parisheka)  with  a  warm  lotion  of  clarified  butter,  oil, 
Dhanyamla  and  essence  of  meat  or  with  a  decoction 
of  the  drugs  that  tend  to  pacify  the  enraged  Vayu 
and  to  relieve  the  pain.  A  swelling  due  to  the  action  of 
the  deranged  Pitta  or  blood  or  to  the  effect  of 
a  blow  or  poison  should  be  washed  or  sprinkle  1 
with  a  lotion  of  milk,  clarified  butter,  honey  and  sugar 
dissolved  in  water,  the  expressed  juice  of  sugar-cane 
and  a  cold  decoction  of  the  drugs  of  the  Madhura  group 
(Kakol>'*adi-gana)  and  the  Kshira-Vriksfias.  A  Kaphaja 
swelling  on  the  body  should  be  washed  or  sprinkled 
with  a  luke-warm  lotion  of  oil,  cow's  urine,  alkaline 
solution,  wine  >^Sura),  Sukta  and  with  a  decoction  of 
drugs  that  destroy  the  deranged  Kapha.     29—31. 

IVIetrical  Text :  —As  a  fire  is  put  out  by  jets  of 
water,  so  the  fire  of  the  deranged  morbific  principles 
(Doshagnl)  of  the  body  are  spe  idily  subdued  and  put  down 
by  the  application  of  (medicinal  lotions)  washes.     32. 


Chap.   I.]  CHIKITSA   STHANAM.  247 

An  anointing  (Abhyanga),  duly  prescribed  and    used, 
with   a    full    regard    to    the    nature   of  the    aggravated 
Doshas,    leads  to    their  pacification  (restoration  to    the 
normal  condition)    and  to  softness  (subsidence)  of   the 
swelling.     33. 

lYICtrical  Texts: — An  application  of  an  anoint- 
ment (Abhyanga)  should  precede  the  measures  of  fomen- 
tation, resolution,  &c  ,  while  it  should  follow  all  evacuating 
measures,  &c.  A  painful,  extended  and  indurated  swell- 
ing, as  well  as  an  ulcer  of  a  similar  nature,  should  be 
fomented,  while  an  act  of  Vimlapana  (resolution  by 
gentle  massage)  should  be  done  in  respect  of  a  fixed  or 
unfluctuating  swelling  attended  with  little  or  no  pain 
whatsoever.  A  wise  physician  should  first  annoint 
and  foment  the  part  and  then  gently  and  slowly  press 
it  with  a  bamboo-reed  or  with  the  back  of  his  thumb 
or  palm.  A  non-suppurated  swelling  or  one  that  is 
partially  suppurated  should  be  treated  with  poultice 
(Upandha\  which  would  lead  to  its  resolution  or  suppu- 
ration, as  the  case  might  be.  A  swelling,  not  resolved 
or  not  subsiding  even  after  the  adoption  of  the  measures 
beginning  with  Apatarpana  and  ending  in  Virechana 
(in  the  given  .  list),  should  be  caused  to  suppurate 
with  the  drugs  enumerated  in  the  ^chapter  of  Mis'raka, 
such  as  curd,  whey,  wine  (Sura),  Sukta  and  Dhany^mla 
(a  kind  of  fermented  paddy  gruel).  They  should  be 
formed  into  a  paste  and  the  paste  should  be  cooked  into 
an  efficacious  poultice-like  composition:(Utk^rikd),  and 
mixed  with  salt  and  oil  or  clarified  butter,  it  should  be 
applied  over  the  affected  part  (swelling)  and  bandaged 
with  the  leaves  of  an  Eranda  plant.  The  patient 
should  be  allowed  to  take  a  wholesome  (?^.,  which  does 
not.  produce  Kapha)  diet  as  soon  as  suppuration  would 
set  in  (in  the  swelling),  34-39. 


248  THE  SUSHRUTA  SAMIilTA .  [Chap.    I. 

Blood-letting'  :— Blood-letting    should    be    re- 
sorted  to    in   a    case     of  newly    formed    swelling     for 
its    resolution    and   for   alleviating   the  pain.     Bleeding 
(Visratvana)  is   recommended   in   the   case  of  an  ulcer 
which  is  indurated,  marked  by    a  considerable   swelling 
and  inflammation  and  is    reddish  black  or  red-coloured, 
extremely  painful,  gagged  in  its  shape  and    considerably 
extended    at    its    base   (congested),  specially  in  the  case 
of  a  poisonous  ulcer,  for  the  subsidence  of  the   pain   and 
for  warding  off  a  process  of    suppuratiou    therein,   either 
by   applying     leeches    or   by    opening   (a    vein    in   the 
locality)  by  means  of  an  instrument.     An  ulcer-patient 
of  a   dry   or   parched    temperament    affected  with   dis- 
tressing supervenients  or  ulcer-cachixia  or  who  is   weak 
should  be  made   to   drink    an    emulsive   potion   cooked 
with    (a   decoction   of)    appropriate   drugs.     A    patient 
afflicted   with   an   ulcer   with   an    elevated    margin  and 
attended    with   swelling   and    specially    marked    by  the 
presence    of    the   deranged    Kapha   and    by   a    flow   of 
blackish    red    blood   should    be   treated   with     emetics. 
Ulcer-experts      recommend     purgatives    to    a     patient 
afflicted  with   an    old    or   long-standing  ulcer,   attended 
with   a    deranged    condition    of    the   Vayu    and    Pitta. 
An  excision  should  be  made  into  an  ulcer  which    refuses 
to  suppurate  and    which   is    of    a    hard    and    indurated 
character  attended  with  sloughing  of  the  local  nerves  and 
ligaments  (Snayu).     An  opening^  or  excision    (Bhedana) 
should  be  made  into   an    ulcer  (Vrana)  in  the    inside  of 
which   pus  has   accumalated  and  makes  it  heave  up  and 
which   not  finding  any  outlet  consequently  eats  into  the 
underlying  tissues  and  makes  fissures  and  cavities.    40-46. 
Measures  which  contribute  to  a  spontaneous  bursting 
by  medicinal  applications  (Da(rana)  of  a  swelling   should 
be  adopted  in  the  case  of  an  infant  or  an  old  or  enfeebled 


Chap,    i.]  CHlklTSA  StHANAM.  249 

patient,  or  of  one  incapable  of  bearing  the  pain  (of  a 
surgical  operation),  or  of  a  person  of  a  timid  disposition, 
as  well  as  in  the  case  of  a  woman,  and  in  the  case  of 
swellings  which  appear  on  the  vulnerable  parts  (Marmas) 
of  the  body.  Remedies  which  lead  to  the  spontaneous 
bursting  of  a  swelling  should  be  applied  by  a  wise 
physician  to  a  well-suppurated  swelling  drawn  up  and 
with  all  its  pus  gathered  to  a  head  ;  or  an  alkaline 
substance  should  be  applied  on  its  surface  and  a 
bursting  should  be  effected  when  the  Doshas  are  found 
to  be  just  aggravated  by   the  incarcerated  pus.     47. 

An  ulcer  which  is  indurated,  whose  edges  are  thick 
and  rounded,  which  has  been  repeatedly  burst  open, 
and  the  flesh  of  whose  cavity  is  hard  and  elevated, 
should  be  scarified  by  a  surgeon  ;  or,  in  other  words, 
an  indurated  ulcer  should  be  deeply  scarified,  one 
with  thick  and  rounded  edges  should  be  excessively 
scarified,  while  the  one  which  has  been  repeatedly 
burst  open  should  be  entirely  scraped  off.  An  ulcer 
with  a  hard  and  elevated  bed  should  be  scraped  evenly 
and  longitudinally  along  the  length  of  its  cavity.  In 
the  absence  of  a  scarifying  instrument,  the  act  should  be 
performed  with  a  piece  of  Kshauma  (cloth  made  of  the 
fibres  of  an  Atasi  plant),  a  linen  (Plota)  or  a  cotton  pad 
(Pichu),  or  with  such  alkaline  substances  as  nitrate  of 
potash,  Samudra-phena,  rock-salt,  or  rough  leaves  of 
trees  (e.  g.,  those  of  Udumbara,  &c.).     48. 

The  cavities  or  courses  of  a  sinus,  or  of  an  ulcer  which 
had  any  foreign  matter  lying  imbedded  in  its  inside,  or 
which  takes  a  crooked  or  round  about  direction,  as  well  as 
of  the  one  formed  into  cavities  within  its  interior,  should 


*    This  scraping  off  of  the  ulcer  should  be  done  by   an   instrument   of 
Surgery  and  not  by  any  rough  leaf  or  the  like,  nien'ioned  hereafter. 

^2 


250  THE   SUSHRUTA  SAMHITA.  [Chap,  t 

be  probed  by  gently  introducing  the  tender  fibres  of 
bamboo  sprouts  (Karira),  a  (lock  of)  hair,  a  finger,  or  an 
indicator  into  its  inside.  The  course  of  a  sinus  occurring 
about  the  anus  or  in  the  region  of  the  eyes  (Netra- 
Vartma)  should  be  probed  with  the  slender  fibres 
of  Chuchchu,  Upodika,  or  Karira,  in  the  event  of 
their  mouths  being  narrow  and  attended  with  bleeding. 
The  Salya  (incarcerated  pus,  etc.)  should  be  extricated, 
whether  the  mouth  of  the  sinus  is  constricted  or  other- 
wise, in  conformityw  ith  the  directions  laid  down  before 
on  that  behalf.  In  diseases  amenable  to  acts  of  punctur- 
ing (Vyadhana),  the  knife  should  be  inserted  into  the 
seat  of  the  disease  to  a  proper  depth  and  extent,  to  be 
determined  by  its  situation  in  the  body,  and  the 
Doshas  (pus,  etc.)  should  be  let  out,  as  stated  before. 
Ulcers  with  a  wide  mouth,  unattended  with  any  symptoms 
of  suppuration,  and  occurring  in  a  fleshy  part  of  the 
body,  should  be  sutured  up,  and  the  adhesion  (San- 
dhana)  of  the  edges  should  likewise  be  effected,  as  direct- 
ed before.  A  plaster  composed  of  drugs  (capable  of 
drawing  out  and  secreting  the  pus),  as  described  before, 
should  be  applied  around  the  mouth  of  an  ulcer  seated 
in  any  of  the  Marmas  (vulnerable  parts),  or  full  of  pus 
in  its  inside,  with  a  narrow-mouthed  aperture.  The 
plaster  should  be  removed  when  dry,  and  should  not 
be  applied  on  the  orifice  of  the  ulcer,  as  it  would,  in  that 
case,  interfere  with  the  spontaneous  secretion  of  pus 
(Dosha).     49-54- 

An  excessive  haemorrhage  incidental  to  such  acts,  as 
excessive  hurting  of  the  vein,  etc.,  should  be  arrested  with 
suitable  styptic*  measures  and  remedies  (Sonitasthdpana). 


*     Styptic  measures  are  of  four  kinds— Sandhana,Skandana,  Pachana, 
and  Dahana.     See  Sutra- Sthanam,  Chap.  XIV. 


Chap.  I.J  CHIKITSA  STHANAM.        .  25 1 

An  ulcer  attended  with  fever,  suppuration  and  burning 
sensation  due  to  the  excited  state  of  the  deranged 
Pitta  and  congestion  of  blood  should  be  allayed  (Nir- 
vapana — literally  putting  out)  with  suitable  and  proper 
medicinal  remedies.  It  should  be  allayed  with  com- 
pounds made  up  of  the  proper  cooling  drugs  (of  the 
Mis'raka  chapter),  pasted  with  milk  and  lubricated  with 
clarified  butter.  Cooling  plasters  (Lepa)  should  then  be 
applied  as  well.     55-56. 

An  ulcer  whose  flesh  is  eaten  away,  which  discharges 
a  thin  secretion,  or  is  non-suppurating  in  its  character, 
and  is  marked  by  roughness,  hardness,  shivering  and 
the  presence  of  an  aching  and  piercing  pain,  should 
be  fomented  with  a  poultice-like  efficacious  preparation 
(UtkairikaL  )cooked  with  the  drugs  of  Vayu-subduing 
properties,  those  included  within  the  Amla-varga,  and 
those  which  belong  to  the  Kdkolyddi  group,  and  with 
the  oily  seeds  (such  as  linseed,  sesamum,  mustard, 
castor,  etc.).  An  indurated,  painful,  faetid,  moist  and 
slimy  ulcer  should  be  washed  with  a  disinfectant  or 
purifying  lotion  consisting  of  a  decoction  of  the  drugs 
mentioned  before  for  the  purpose.     57-58. 

Plugs  or  lints  plastered  with  a  paste  of  the  purifying 
drugs  (enumerated  before)  should  be  inserted  into  an 
ulcer  with  any  foreign  matter  (e.g.,  pus)  lying  embedded 
in  it,  or  into  one  with  a  deep  but  narrow  opening,  or  into 
one  situated  in  a  fleshy  part  of  the  body.  An  ulcer  full 
of  putrid  flesh  and  marked  by  the  action  of  the  highly 
deranged  Doshas  (Vayu  and  Kapha)  should  be  purified 
with  a  paste  of  the  aforesaid  available  drugs  making  up 
the  plug.  An  ulcer  of  a  Pittaja  origin,  which  is  deep- 
seated  and  attended  with  a  burning  sensation  and  with 
suppuration,  should  be  purified  with  the  application  of 
^  medicated  clarified  butter,  prepared  with  the  purifying 


252  THE   SUSHRUTA    SAMHITA.  tChap.  I. 

drugs  with  an  admixture  of  Kdrpasa-phala*.  An 
intelligent  Surgeon  should  purify  an  ulcer  with  raised 
flesh,  and  which  is  dry  and  is  attended  with  scanty 
secretion  with  an  application  of  medicated  mustard  oil. 
An  indurated  ulcer,  refusing  to  be  purified  with  the  fore- 
going medicated  oils,  should  be  purified  with  a  duly 
prepared  decoction  of  the  drugs  enumerated  before 
(Sutra,  chap.  38,— the  Salas^rddi  group)  and  prepared  in 
the  following  manner  of  Rasa-kriyat.  A  decoction  of 
the  said  drugs  duly  prepared  should  be  saturated  with 
an  after- throw  of  Haritdla,  Manahs'ild,  Kdsisa  and 
Smirdshtra  earth,  and  well  compounded  together  ;  the 
preparation  should  also  be  mixed  with  the  expressed 
juice  of  Mdtulunga  and  with  honey.  The  medicine  thus 
prepared  should  be  applied  to  the  ulcer  on  every  third 
or  fourth  day.     59. 

Deepf  and  foul-smelling  ulcers  covered  with  layers 
of  deranged  fat  (phlegmonous  ulcer)  should  be  purified 
by  the  learned  physician  with  the  powders  of  the  drugs 
with  which  the  purifying  plug  or  the  lint  has  been 
enjoined  to  be  plastered  (Ajagandha,  &c.).  Decoctions 
of  the  drugs  which  are  possessed  of  the  virtue  of  setting 
in  a  process  of  granulation  (Ropana)  in  an  ulcer,  sucn 
as  Vata,  &c.,  as  stated  before,  should  be  used  by  a 
surgeon  (Vaidya)  after  it  had  been  found  to  have  been 
thoroughly  purified.  Medicated  plugs,  composed  of 
drugs  possessing  healing  properties  (such  as,  So7na,Amritd, 
As'vagandhd^  etc})  should  be  inserted  in  deep-seated  ulcers, 
when  cleansed  and  unattended  with  pain.     60-62. 

*  The  total  weight  of  the  purifying  drugs  should  be  equal  to  that  of 
the  Karpasa-phala  alone  and  they  should  be  boiled  together  with  four  times 
their  qnantity  of  clarified  butter  and  with  sixteen  times  of  water. 

t  There  is  a  difTerent  reading  of  "Agambhira"  in  place  of  "Gabhira," 
but  Gayi  thinks  the  emendation  undesirable. 


Chap.  I.]  CHIKITSA   STHANAM.  2^3 

A  Kalka  or  a  levigated  paste  of  sesamum  and 
honey  (mentioned  in  the  Misraka  Chapter)  should  be 
applied  for  the  purpose  of  healing  up  an  ulcer  situated 
in  a  muscular  part  from  which  all  putrid  flesh  has 
been  removed  or  sloughed  off  and  which  exhibited  a  clear 
cavity.  This  paste  (of  sesamum)  tends  to  allay  the 
deranged  Vayu  through  its  sweet  taste,  oleaginous- 
ness  and  heat-making  potency  ;  subdues  the  deranged 
Pitta  through  its  astringent,  sweet  and  bitter  taste  and 
proves  beneficial  even  in  the  case  of  the  deranged 
Kapha  through  its  heat-producing  potency  and  bitter 
and  astringent  taste.  An  application  of  the  levigated 
paste  of  sesamum  mixed  with  the  drugs  of  purifying  and 
healing  properties  tends  to  purify  and  heal  up  an  ulcer. 
An  application  of  the  levigated  paste  of  sesamum  mixed 
with  honey  and  Nimda-\es.ves  leads  to  the  purification 
of  sores  ;  whereas  an  application  of  the  same  paste 
(?> ,  sesamum,  honey  and  leaves  of  Nimbd),  mixed  with 
clarified  butter  tends  to  heal  up  the  ulcer.  Several 
authorities  atribute  the  same  virtue  to  a  barley-paste.* 
Levigated  pastes  of  barley  and  of  sesamum  (or  a  paste  of 
barley  mixed  with  sesamum)  contribute  to  the  resolution 
or  subsidence  of  a  non-suppurated  swelling,  fully  suppur- 
ate one  which  is  partially  suppurated,  lead  to  the  spon- 
taneous bursting  of  a  fully  suppurated  one,  and  purify 
as  well  as  heal  up  one  that  has  already  burst  out.    63-65. 

An  ulcer,whicb  is  due  to  the  effects  of  poison,  vitiated 
blood,  or  aggravated  Pitta,  and  which  is  deep-seated  oris 
of  traumatic  origin,  should  be  healed  up  with  a  medicated 
clarified  butter  prepared  with  the  drugs  of  healing  virtues 
(Ropaniya— enumerated  before)  and  milk.  An  ulcer 
marked   by   an    aggravated   condition   of  the  deranged 

Jejjada  and   Gayadasa   interpret   the  term    to  mean  '*barley-paste 
mixed  with  sesamum." 


254  THE   SUSHRUTA   SAMHITA.  [Chap.  I. 

Vayu  and  Kapha  should  be  healed  up  with  the  applica- 
tion of  an  oil,  boiled  and  prepared  with  the  proper 
purifying  drugs  mentioned  before.     66  6y. 

Rasa-kriyat*  with  the  two  kinds  of  Haridrd  should 
be  resorted  to  for  the  purpose  of  healing  up  an  ulcer,  in 
which  bandaging  is  forbidden  (such  as  those  due  to  the 
deranged  Pitta  or  blood,  or  to  blow,  &c.,  or  to  the  effects 
of  poison),  and  an  ulcer  appearing  on  the  moveable 
joints,  which,  though  exhibiting  all  the  features  of 
a  well-cleansed  sore,  has  not  been  marked  by  any  process 
of  healthy  granulationf.  Healing  medicinal  powders 
should  be  used  in  the  case  of  an  ulcer  which  is  con- 
fined to  the  skin,  and  is  firm-fleshed  and  marked  by 
the  absence  of  any  irregularity  in  its  shape  {i.e.^  not 
uneven  in  its  margin).  The  mode  of  applying  medicinal 
powders,  as  stated  in  the  Sutra-sthana,  should  be  adopted 
in  the  present  instance.     68-69. 

The  healing  and  purifying  measures  described  above 
should  be  deemed  equally  applicable  to,  and  efficacious 
in  cases  of  ulcers  in  general  with  regard  to  their 
Doshas  (both  idiopathic  and  traumatic).  The  success 
of  these  measures  has  been  witnessed  in  thousands  of 
cases  and  has  been  recorded  in  the  Sastras  (authorised 
works  on  medicine).  Hence  they  should  be  used  as 
incantations  without  any  doubt  as  to  their  tested  and 
infallible  efficacy.  An  intelligent  physician  should 
employ  the  drugs,  mentioned  before,  in  any  of  the 
seven  forms  (either  in   the    shape   of  a   decoction,   or  a 

*  The  decoction  of  IriphalA  and  the  drugs  of  the  Nyagrodhadi  group 
should  be  duly  prepared,  filtered  and  then  condensed  to  the  consistency  of 
tteacle.  Powders  of  Haridrd  and  Daru-haridra  should  be  then  thrown 
into  it.  In  the  end,  the  whole  preparation  should  be  well-stirred, 
mixed  with  honey  and  applied.     This  is  what  is  called  Rasa-kriya. 

t     Several  editions  read  "though  cleansed  yet  ungranulating  ulcere." 


Chap,  t]  CHlklTSA  STHANAM.  2^5 

plug,  or  a  paste,  or  through  the  medium  of  medicated  oils 
and  clarified  butter,  or  in  the  shape  of  Rasa-kriya,  or  as 
powders),  according  to  the  requirements  of  each  case.  70. 

The  drugs  which  constitute  the  two  groups  ofPancha- 
mulas  (major  and  minor),  as  well  as  those  of  the  Vayu- 
subduing  group,  should  be  employed  in  the  case  of  an  ulcer 
due  to  the  aggravated  Vatyu  in  any  of  the  seven  forms 
— decoction,  etc.  Similarly  the  drugs  which  are  included 
within  the  groups  of  Nyagrodhadi  or  Kakolyadi  should 
be  used  in  any  of  those  seven  forms,  in  the  case  of  an 
ulcer  due  to  the  aggravated  Pitta  (for  the  purification 
and  healing  thereof).  Drugs  which  form  the  group  of 
Aragvadhadi,  as  well  as  those  which  have  been  des- 
cribed as  heat-making  in  their  potency,  should  be  used 
in  any  of  those  seven  aforesaid  forms,  in  the  case  of 
an  ulcer  due  to  the  deranged  Kapha.  The  drugs  of  two 
or  three  of  those  groups,  should  be  combinedly  used 
in  any  of  those  seven  forms,  in  connection  with  an 
ulcer  marked  by  the  aggravated  condition  of  any  two 
or  three  of  the  deranged  Doshas  respectively.  71-74. 

Fumig'ation  : — Vataja  ulcers  with  severe  pain 
and  secretion  should  be  fumigated  with  the  fumes  of 
Ks/iauma,  barley,  clarified  butter  and  other  proper  fumi- 
gating substances  [such  as  turpentine  and  resin  (gum  of 
Sdlatree)].     75. 

Utsadana-Kriya  (Elevation)  :— Medicated 
plasters  (consisting  of  Apdmdrga,  As'va^andhd,  etc.)  and 
medicated  clarified  butter  (prepared  with  the  same 
drugs  should  be  used  in  ulcers  (due  to  the  aggravated Vayu 
and  marked  by  the  absence  of  any  secretion,  and  affecting 
a  considerably  smaller  area  or  depth  of  flesh,  as  well 
as  in  those  (due  to  the  deranged  and  aggravated  Pitta 
and)  seated  deep  into  the  flesh,  for  the  purpose  of  raising 
up  (filling  up)  the  beds  or  cavities  thereof.  Meat  of  carni- 


256  THE  SUSHRUTA  SAMHITA.  tChap.  t. 

vorous  animals  should  be  taken  in  the  proper  manner  by 
the  patient,  inasmuch  as  meat  properly  partaken  of  in 
a  calm  and  joyful  frame  of  mind  adds  to  the  bodily  flesh 
of  its  partaker.     J6. 

Ava.Sada.na  (destruction  of  super-growths) : — 
Proper  drugs  or  articles  (such  as  sulphate  of  copper, 
etc.)  powdered  and  pasted  with  honey  should  be  applied 
for  destroying  the  soft  marginal  growths  of  an  ulcer 
found  to  be  more  elevated  than  the  surrounding  surface 
of  the  affected  locality.     77. 

IVI  rid U- Karma  (softening)  :— In  respect  of 
indurated  and  fleshless  (not  seated  in  a  part  of  the  body 
where  flesh  abounds)  ulcers  marked  by  a  deranged 
condition  of  Vayu,  softening  measures  (with  the 
help  of  repeated  applications  of  lotions  and  plasters 
composed  of  sweet  and  demulcent  substances  mixed 
with  salt  in  a  tepid  or  luke-warm  state)  and  blood- 
letting* should  be  resorted  to.  Sprinkling  (Seka)  and 
application  of  clarified  butter  or  oil  prepared  with  the 
Vayu-subduing  drugs  should  also  be  resorted  to.     yZ. 

D^runa-karma:— The  employment  of  harde- 
ning measures  (Daruna-karma)  is  efficacious  in  con- 
nection with  soft  ulcers  and  in  the  following  man- 
ner. Barks  of  Dhava,  Priyangu,  As' oka,  Rohini^ 
Triphala,  Dhdtaki  flowers,  Lodhra  and  Sarjarasa^  taken 
in  equal  parts  and  pounded  into  fine  powders,  should  be 
strewn  over  the  ulcer,  i.e.,  the  ulcer  should  be  dusted 
with  the  same.     79. 

Kshara- Karma  (Potential  cauterization)  :  — 
The  measure  of  applying  alkali  should  be  adopted  for  the 

*  Blood-letting  should  be  resorted  to  in  the  event  of  any  vitiated 
blood  being  found  to  have  been  involved  in  the  case  ;  but  in  the  event  of 
a  similar  participation  of  any  deranged  Kapha,  oils  and  lotions  composed 
of  the  Va'yu-destroying  drugs  should  be  made  use  of. 


Chap.  I.]  CHIKITSA  STHANAM.  257 

purification  of  the  sore  of  a  long-standing  ulcer  which  is 
of  an  indurated  character  with  its  margin  raised  higher 
(than  the  surrounding  skin),  and  is  marked  by  itching 
and  a  stubborn  resistance  to  all  purifying  medicines.  80. 
Agni-Karma  (actual  cauterization)  :— An  ulcer 
incidental  to  an  act  of  lithotomic  operation  allowing  the 
urine  to  dribble  out  through  its  fissure,  or  one  marked 
by  excessive  bleeding,  or  in  which  the  connecting  ends 
have  been  completely  severed,  should  be  actually  cauter- 
ised with  fire.     81 . 

Krishna- Karma  : -The  blackening  of  a 
white  cicatrix,  which  is  the  result  of  a  bad  or  defective 
granulation,  should  be  made  (after  the  complete  healing 
up  of  the  ulcer)  in  the  following  manner.  Several  Bhalld' 
taka  seeds  should  be  first  soaked  in  the  urine  of  a  cow 
(and  then  dried  in  the  sun,  this  process  should  be 
repeated  for  seven  days  consecutively),  after  which  they 
should  be  kept  (a  week)  immersed  in  a  pitcher  full  of 
milk.  After  that  the  seeds  should  be  cut  into  two  and 
placed  in  an  iron  pitcher.  Another  pitcher  should  be 
buried  in  the  ground  with  a  thin  and  perforated  lid 
placed  over  its  mouth,  and  the  pitcher  containing  the 
seeds  should  be  placed  upon  it  with  its  mouth  downward 
(so  that  the  mouths  of  the  two  pitchers  might  meet),  and 
then  the  meeting  place  should  be  firmly  joined  (with 
clay).  This  being  done  a  cow-dung  fire  should  be  lit 
around  the  upper  pitcher.  The  oily  matter  (melted  by 
the  heat)  and  dribbling  down  from  the  Bhallataka  seeds 
into  the  underground  pitcher  should  be  slowly  and  care- 
fully collected.  The  hoofs  of  village  animals  (such  as 
horses,  etc.)  and  those  which  live  in  swamps  (Anupas  — 
such  as  buffaloes,  etc.)  should  be  burnt  and  pounded 
together  into  extremely  fine  powder.  The  oil  (of  the 
Bhalldtaka   seeds  collected    as   above)   should   then   be 


258  THE   SUSHRUTA   SAMHITA.  [Chap.  I. 

mixed  with  this  powder,  and  applied  to  the  white 
cicatrix.  Similarly,  the  oily  essence  of  the  piths  of 
some  kinds  of  wood,  as  well  as  of  some  kinds  of  fruit 
{Phala-snehd)  prepared  in  the  manner  of  the  Bhalldtaka 
oil  (and  mixed  with  the  powdered  ashes  of  hoofs)  should 
be  used  for  the  blackening  of  a  cicatrix.     82-83. 

PandU-karana  :— The  natural  and  healthy 
colour  (Pdndu)  of  the  surrounding  skin  should  be  im- 
parted to  a  cicatrix  which  has  assumed  a  black  colour 
owing  to  the  defective  or  faulty  healing  up  of  the  sore  in 
the  following  manner.  The  fruit  of  the  Rohini*  should  be 
immersed  in  goat's  milk  for  seven  nights  and,  afterwards 
finely  pasted  with  the  same  milk,  should  be  applied 
to  the  skin.  This  measure  is  called  Fandu-karana 
(imparting  a  yellow  or  natural  skin-colour  to  the 
cicatrix).  To  attain  the  same  result,  the  powder  of  a 
new  earthen  pot,  Vetasa  roots,  S'dla  roots.  Sulphate  of 
iron,  and  Madhuka  (Yashti-madhu)  pasted  together  with 
honey  may  be  used.  As  an  alternative,  the  hollow  rind 
of  the  Kapittha  fruit,  from  which  the  pulp  has  been 
removed,  should  be  filled  with  the  urine  of  a  goat  to- 
gether with  Kasisa  (Sulphate  of  iron),  Rockand,  Tuttham 
(Sulphate  of  copper).  Haritdla^  Manahsild,  scrapings 
of  raw  bamboo  skin,  Prapunndda  (seeds  of  Chakunde), 
and  Rasanjana  and  buried  a  month  beneath  the  roots 
of  an  Arjuna  tree  after  which  it  should  be  taken  out 
and  applied  to  the  black  cicatrix.  The  shell  of  a  hen's 
egg,  Kataka^  Madhuka,  (Yashti-madhu),  sea-oysters  and 
crystalsf  (pearls  according  to  Jejjata  and  Brahmadeva) 
taken  in  equal  parts  should  bs  pounded  and  pasted  with 


•  Rohini,  according  to  som^  co nmentators,  means  a  kind  of  Haritaki  ; 
according  to  others,  it  means  Ka*u-tumbi. 

I  Burnt  ashes  of  sea-oysters,  and  pearls  etc.,  should  be  used. 


Chap.  I.]  CHIKITSA  STHANAM.  2^9 

the  urine  of  a  cow  and  made  into  boluses   which  should 
be  rubbed  over  the  cicatrix  *     84-87. 

Roma-Sanjanana— hair-producers  :—       The 

burnt  ashes  of  ivory  and  pure  Rasdnjana  (black 
antimony;  pounded  (and  pasted  with  goat's  milk)  should 
be  applied  to  the  spot  where  the  appearance  of  hair 
{Lomotpatti)  is  desired.  An  application  of  this  plaster 
would  lead  to  the  appearance  of  hair  even  on  the  palms 
of  the  hands.  Another  alternative  is  a  pulverised 
compound  consisting  of  the  burnt  ashes  of  the  bones, 
nails,  hair,  skin,  hoofs  and  horns  of  any  quadruped, 
over  a  part  of  the  body,  previously  anointed  (rubbed) 
with  oil,  which  would  lead  to  the  appearance  of  hair  in 
that  region.  And  lastly,  a  plaster  composed  of  Sulphate 
of  iron,  and  tender  Karanja  leaves  pasted  with  the 
expressed  juice  of  Kapittha,  would  be  attended  with 
the  same  result.     88  —  90. 

Hair-dcpilators '.—The  hair  of  an  ulcer- 
ated part  of  the  body  found  to  interfere  with  the  satis- 
factory healing  up  of  the  ulcer,  should  be  shaved  with 
a  razor  or  clipped  with  scissors,  or  rooted  out  with  the 
help  of  forceps.  As  an  alternative,  an  application  of  a 
plaster  consisting  of  two  parts  of  pulverised  (burnt  ashes 
of)  conch-shell  and  one  part  oi  Haritdla  (yellow  orpiment 
or  yellow  oxide  of  arsenic)  pasted  with  Sukta  (an 
acid  gruel)  over  the  desired  spot,  would  be  attended 
with  the  same  result  A  compound  made  of  the  oil  of 
Bhallattaka  mixed  with  the  milky  exudation  of  Snuhi, 
should  be  used  by  an  intelligent  physician  as  a  depila- 
tory measure.  As  an  alternative,  the  burnt  ashes  of  the 
stems  of  plantain  leaves  and  Dirghavrinta  (Syondka) 
mixed  with  rock-salt,  Haritdla  and    the   seeds    of  Sami, 

*  This  also  is  a  remedy  for  giving  a  natural  colour  to  the  skin. 


26o  THE   SUSHRtJTA  SAMHITA.  [Chap.  I. 

pasted  with  cold  water,  should  be  deemed  a  good  hair- 
depilatory.*  A  plaster  composed  of  the  ashes  of  the 
tail  of  a  domestic  lizard,  plantain,  Haritala  (oxide  of 
arsenic),  and  the  seeds  of  Ingudi  burnt  together:  and 
pasted  with  oil  and  water,  and  baked  in  the  sun  may 
also  be  used  for  the  eradicating  of  hair  in  the  affected 
locality.     94-95. 

Vast! -Karma  :— A  medicated  Vasti  (enema) 
should  be  applied  to  the  rectum  in  the  case  of  an  ulcer 
marked  by  an  aggravated  condition  of  the  deranged 
Vayu  which  is  extremely  dry  and  is  attended  with  an 
excruciating  pain  occurring  specially  in  the  lower  region 
of  the  body.  A  measure  of  Uttara-vasti  (Vaginal  or 
Urethral  syringe)  should  be  adopted  in  the  cases  of 
strictures  and  other  disorders  connected  with  urine, 
semen  and  menstruation,  as  well  as  in  cases  ot 
gravel  ^  in  case  these  are  due  to  an  ulcer.  An  ulcer  is 
purified,  softened  and  healed  up  by  bandaging  leaving 
no  room  for  the  apprehension  of  a  relapse.  Hence 
bandaging  is  recommended.     96-98. 

Patradana  (application  of  leaves  on  an  ulcer)  : — 
Leaves  possessed  of  proper  medicinal  virtues  taking 
into  consideration  the  particular  Dosha  and  season  of  the 
year  should  be  tied  (over  the  medicinal  plaster  applied) 
over  an  ulcer  of  non-shifting  or  non-changing  character 
and  not  affecting  a  large  depth  of  flesh  and  which 
refuses  to  be  healed  up  owing  to  its  extreme  dryness. 
An  ulcer  of  the  deranged  Vayu  should  be  tied  over  with 
the  leaves  of  the  Eranda,  Bhurfa,  Putika,  or  Haridrd 
plants  as  well  as  with  those  of  the  Upodikd  and 
Gdmbhdri.   An  ulcer  marked  by  an  aggravated  condition 

*     According  lo  seme  this  may  be  used  internally  for  the  purpose. 

t    D.  R.  Some  read  "Tathaiiiile"  in  place  of  ♦•As'mari-vrane." 

."Taiharjile"  means  and  in  cases  of  (aggravated)  Vayu. 


Chap.  I.]  CHIKITSA   STHANAM.  26l 

of  the  deranged  Pitta,  or  incidental  to  a  vitiated  condi- 
tion of  the  blood,  should  be  tied  in  the  aforesaid  manner 
with  the  leaves  of  the  Kds'mari,  the  Kshira  trees  (milk- 
exuding  trees),  and  aquatic  plants.  An  ulcer  due  to  the 
deranged  and  aggravated  Kapha,  should  be  tied  over 
with  the  leaves  of  the  Pdthd,  Murvd,  Guduchi,  Kdka- 
mdchi,  Haridrd  or  of  the  S'ukandsd,  Only  those  leaves 
which  are  not  rough,  nor  putrid,  nor  old  and  decomposed, 
nor  worm-eaten  and  which  are  soft  and  tender  should.be 
used  for  purposes  of  Patradana.*  The  rationale  of  such 
a  procedure  (Patra-vandha)  is  that  the  leaves  tied  by  an 
intelligent  physician  in  the  manner  above  indicated 
serve  to  generate  heat  or  cold  and  retain  the  liniment 
or  medicated  oil  in  their  seat  of  application.     99-102. 

Vermifugal  :— The  germination  of  worms  due 
to  flies  in  an  ulcer  is  attended  with  various  kinds  of 
extreme  pain,  swelling  and  bleeding  in  case  the  worms 
eat  up  the  flesh.  A  decoction  of  the  drugs  of  the 
Suras ddi  gana  proves  efficacious  as  a  wash  and  healing 
medicine  in  such  a  case.  The  ulcer  should  be  plastered 
with  such  drugs  as  the  bark  of  Saptaparna,  Karanja, 
Afka,  Nimba,  and  Rdjddana  pasted  with  the  urine  of  a 
cow,  or  washed  with  an  alkaline  wash  (for  expelling  the 
vermin  from  it).  As  an  alternative,  the  worms  should  be 
brought  out  of  the  ulcer  by  placing  a  small  piece  of  raw 
flesh  on  the  ulcer.  These  vermin  may  be  divided  into 
twenty  groups  or  classes,  which  will  be  fully  dealt  with 
later  on.     (Uttara-Tantram-  ch.  54).     103. 

Vrinhanam  (use  of  restorative  and  constructive 
tonics)  : — All  kinds  of  tone-giving  and  constructive 
measures  should  be  adopted    in    the    case   of  a   patient 

The  leaf  which  does  not  poison  the  Sneha  and  the  esserxe  of  the 
medicinal  drugs  placed  in  a  folded  piece  of  linen  (and  applied  over  an 
ulcer  is  the  proper  leaf  and)  should  be  used  for  tying  over  the  paste. 


262  THE   SUSHRUtA  SAMHITA.  [Chap.  t. 

weak  and  emaciated  with  the  troubles  of  a  long-standing 
sore,  taking  full  precaution  not  to  tax  his  digestive 
powers.  Anti-toxic  (Vishaghna)  medicines  and  measures 
and  symptoms  of  poisonings  will  be  described  under 
their  respective  heads  in  the  Kalpa-Sthanam.     104-105. 

^iro-vircchana  and   Nasya  :-S'iro-vire- 

chana  measures  (errhines)  should  be  resorted  to  by 
skilful  physicians  in  respect  of  ulcers  situated  in  the 
clavicle  regions  and  marked  by  itching  and  swelling. 
The  use  of  medicated  (fatty)  snufF  (Nasya)  is  recom- 
mended in  cases  where  the  ulcers  would  be  found  to  be 
seated  in  the  regions  above  the  clavicles  and  marked  by 
an  aggravated  condition  of  the  deranged  Vayu,  pain, 
and  absence  of  the  oily  matter.      106-107. 

Kavala-dharana  :— Medicated  gargles  (^con- 
sisting of  decoctions  of  drugs)  of  purifying  or  healing 
virtues  either  hot  or  cold  *  (according  to  require- 
ments) should  be  used  in  the  case  of  an  ulcer  in  the 
mouth,  for  the  purpose  of  alleviating  the  Doshas  therein, 
for  allaying  the  local  pain  and  burning,  and  for  removing 
the  impurities  of  the  teeth  and  the  tongue.  108. 

Dhuma-pana  :  —inhaling  of  smoke  or  vapours 
(of  medicated  drugs)  should  be  prescribed  in  cases  of  ulcers 
of  the  deranged  Vayu  and  Kapha  attended  with  swelling, 
secretion  and  pain  and  situated  in  the  region  above  the 
clavicles.  Application  of  honey  and  clarified  butter,  se- 
parately or  mixed  together  should  be  prescribed  in  cases 
of  extended  or  elongated  ulcers  which  are  traumatic  or 
incidental  in  their  character  (Sadyo-Vrana)  for  allaying 
the  heat  of  the  ulcer  and  for  bringing  about  its  adhe- 
sion .     Surgical  instruments  should  be  used  in  connec- 

*  Hot  gargles  are  recommended  in  cases  of  ulcers  of  the  deranged 
Vayu  and  Kapha  while  cold  ones  in  cases  of  ulcers  of  the  aggravated  Pitta 
and  blood. 


Chap.  I.]  CHIKITSA  STHANAM.  263 

tion  with  an  ulcer  which  is  deep-seated  but  provided 
with  a  narrow  orifice  and  which  is  due  to  the  pene- 
tration of  a  Salya  (shaft)  and  which  could  not  be  re- 
moved with  the  hand  alone.     109-111. 

The  diet  of  an  ulcer-patient  should  in  all  cases  be 
made  to  consist  of  food  which  is  light  in  quantity 
as  well  a?  in  quality,  demulcent,  heat-making  (in  potency) 
and  possessed  of  appetising  properties*  Protective  rites 
should  be  performed  for  the  safety  of  an  ulcer-patient 
from  the  influences  of  malignant  stars  and  spirits  with 
the  major  and  the  minor  duties  (Yama  and  Niyama) 
enjoined  to  be  practised  on  his  behalf.     112-113. 

The  causes  of  ulcers  are  sixf  ;  their  seats  in  the 
body  number  eight|  in  all  ;  the  features  which  charac- 
terise them  are  five  $.  The  medicinal  measures  and 
remedies  in  respect  of  ulcers  are  sixty  Ij  in  number. 
And  these  ulcers  are  curable  with  the  help  or  co-opera- 
tion of  the  four  necessary  factors  (the  physician,  the 
medicines,  the  nurse  and  the  patient).     114. 

The  comparatively  smaller  number  of  drugs  which 
I  have  mentioned  (under  the  heads  of  Ropana, 
Sodhana,  etc.,  in  the  present  chapter)  from  fear  of 
prolixity,  may  be  increased  in  combination  with  other 
drugs  or  substances  of  similar  virtue,  (digestionary  trans- 
formation   and    potency,   etc.)  without  any  apprehension 

*     See  Chap.  XIX.— Sutra-Sthanam. 

t  The  six  causes  of  an  ulcer  are  Vayu,  Pitta,  Kapha,  Sannipdta, 
S'onita  aud  Agantu. 

t  The  eight  seats  of  an  ulcer  are  Tvak,  Mansa,  S'ira,  Snayu,  Sandhi, 
Asthi,  Koshlha  and  Marma. 

§  The  five  symptoms  of  an  ulcer  are  due  to  Vata,  Pitta,  Kapha, 
Sannipata  and  Agantu.  The  symptoms  due  to  S'onita  being  identical 
with  those  due  to  Pitta,  are  not  separately  counted. 

II  The  sixty  medicinal  measures  and  remedies  are  those  describee^ 
before  in  the  present  chapter. 


264  THE  SUSHRUTA  SAMHITA.  [Chap.  I. 

of  doing  any  mischief  thereby.  Recipes  consisting 
of  rare  or  a  large  number  of  drugs  or  ingredients, 
should  be  made  up  with  as  many  of  them  as  would  be 
available  in  the  absence  of  all  of  them,  as  mentioned 
in  the  present  work.  A  drug  belonging  to  any  parti- 
cular Gana  or  group  if  separately  described  as  non- 
efficacious  to  any  specific  disease,  should  be  omitted 
whereas  a  drug  not  belonging  to  a  group  may  be  added 
to  it  if  it  is  elsewhere  laid  down  as  positively  beneficial 
thereto.     11 5-1 17. 

Upadrava  : — The  distressing  supervening  symp- 
toms which  are  found  to  attend  a  case  of  ulcer,  are  quite 
different  from  those  of  an  ulcer-patient.  Those  which 
confine  themselves  solely  to  the  ulcer  are  five  in  all — 
smell,  colour,  etc.,  and  those  which  are  exclusively  mani- 
fest in  the  patient  are  fever,  diarrhoea,  hiccup,  vomit- 
ing, fainting  fits,  aversion  to  food,  cough,  difficult 
breathing,  indigestion  and  thirst.  The  medical  treat- 
ment of  ulcers  though  described  in  detail  in  the  present 
chapter,  will  be  further  dealt  with  in  the  next  chapter 
on  Sadyo-Vrana.     118-120. 

Thus  ends  the  first  Chapter  of  the  Chikitsita-Sthanam  in   the    Sus'ruta 
Samhita  which  deals  with  the  treatment  of  the  two  kinds  of  ulcer. 


CHAPTEK  II. 

Now  we  shall  discourse  on  the  medical  treatment  of 
recent  or  traumatic  wounds  or  sores  (SadyOVrana- 

Chikitsa).    i, 

Metrical  Texts;  -The  holy  Dhanvantari,  the 
foremost  of  the  pious  and  the  greatest  of  all  discoursers, 
thus  discoursed  to  his  disciple  Susruta,  the  son  of 
Visvdmitra.     2. 

Different  Shapes  Of  Sores  :— I  shall  de- 
scribe the  shapes  of  the  various  kinds  of  Vrana  (sores 
or  wounds)  caused  by  weapons  of  variously  shaped  edges 
in  the  different  parts  of  the  human  body.  Traumatic 
ulcers  have  a  variety  of  shapes.  Some  of  these  are 
elongated,  others  are  rectangular,  or  triangular,  or 
circular,  while  some  are  crescent  shaped,  or  extended,  or 
have  a  zigzag  shape,  and  some  are  hollow  in  the  middle 
like  a  saucer,  and  lastly  some  have  she  shapes  of  a 
barley  corn  (bulged  out  at  the  middle).  An  abscess 
or  a  swelling,  due  to  the  several  Doshas  and  which 
spontaneouly  bursts  out,  may  assume  any  of  the  aforesaid 
forms,  while  the  one  effected  by  a  surgeon's  knife  should 
never  have  a  distorted  or  an  improper  shape.  A  surgeon 
thoroughly  familiar  with  the  shapes  of  ulcers  is  never 
puzzled  at  the  sight  of  one  of  a  terrible  and  distorted 
shape.     3  —  5. 

Physicians  of  yore  have  grouped  these  variously 
shaped  traumatic  ulcers  under  six  broad  sub-heads,  such 
as  the  Chhinna  (cut),  Bhinna  (punctured  or  perforated), 
Viddha  (pierced),  Kshata  (contused),  Pichchita  (crushed), 
and  the  Ghrishta  (mangled  or  lacerated)  according  to 
their  common  features  and  I  shall  describe  their 
symptoms.     6. 

34 


266  THK  SUSHRUTA  SAMIIITA.  [Chap.  II. 

Their  definitions:— A  traumatic  ulcer  which 
is  oblique  or  straight  and  elongated  is  called  a  Chhinna 
l^cut)  ulcer,  while  a  complete  severance  of  a  part  or 
member  of  the  body  is  also  designated  by  that  name, 
A  perforation  of  any  of  the  cavities  or  receptacles  of 
the  body  by  the  tip  of  a  Kunta,  spear,  Rishti,  or  a  sword 
or  by  a  horn,  attended  with  a  little  discharge,  constitutes 
what  is  called  a  Bhinna  (punctured)  wound  or  ulcer. 
The  Amas'aya  (stomachy  the  Pakv^saya  (intestines),  the 
Agnyasaya  (gall-bladder  ?\  the  Mutras'aya  (urinary 
bladder),  the  Raktasaya  (receptacle  of  blood),  the  heart, 
the  Unduka  and  the  lungs  constitute  what  is  called  the 
Koshtha  (viscu>).  A  perforation  (of  the  wall  of  any) 
of  the  As'ayas  causes  it  to  become  filled  with  blood 
which  is  discharged  through  the  urethra,  the  anus,  the 
mouth  or  the  nostrils  and  is  attended  with  fever,  thirst, 
fainting  fits,  dyspnoea,  burning  sensations,  tympanites, 
suppression  of  stool,  urine  and  flatus  (Vata)  with  an 
aversion  for  food,  perspiration,  redness  of  the  eyes,  a 
bloody  smell  in  the  mouth,  and  feted  one  in  the  body 
and  an  aching  pain  in  the  heart  and  in  the  sides.  7 — 10. 

Now  hear  me  discourse  on  (their)  detailed  symptoms. 
A  perforation  of  the  wall  of  the  Ama'saya  (stomach)  is 
marked  by  constant  vomiting  of  blood,  excessive 
tympanites  and  an  excruciating  pain.  A  perforation  of 
the  Pakva's'aya  fills  it  with  blood  and  is  attended  with 
extreme  pain,  a  heaviness  in  the  limbs,  coldness  of  the 
sub-umbilical  region,  and  bleeding  through  the  (lower) 
ducts  and  orifices  of  the  body.  Even  in  the  absence  of 
any  perforation,  the  Antras  (intestines)  are  filled  with 
blood  through  the  small  pores  or  apertures  in  their  walls 
in  the  same  manner  as  a  pitcher  with  its  mouth  firmly 
covered  may  be  filled  through  the  pores  (in  its  sides),  and 
a  sense  of  heaviness  is  also  perceived  in  their  inside,  r  i-i  3. 


Chap.  110  CHIltlTSA  STHANAM.  '267 

A  wound  or  an  ulcer  caused  by  any  sharp  pointed 
Salya  (shaft)  in  any  part  of  the  body  other  than  the 
aforesaid  As'ayas  with  or  without  that  Salya  being  extri- 
cated is  called  a  Viddha  (pierced  one).  An  ulcer  which 
is  neither  a  cut  nor  a  perforation  or  puncture  but  partakes 
of  the  nature  of  both  and  is  uneven  is  called  a  Kshata 
(wound).  A  part  of  the  body  with  the  local  bone 
crushed  between  the  folds  of  a  door  or  by  a  blow  be- 
comes extended  and  covered  with  blood  and  marrow  and 
is  called  a  Pichchita  (thrashed)  wound  or  ulcer.  The 
skin  of  any  part  of  the  body  suffering  abrasion  through 
friction  or  from  any  other  such  like  causes  and  attended 
with  heat  and  a  secretion  is  called  a  Ghrisbta  (mangled 
or  lacerated)  wound  or  ulcer.      14-17. 

Their  Treatment  :  —A  part  or  member  of  the 
body  any  wise  cut,  perforated,  pierced  or  wounded  which 
is  attended  with  excessive  bleeding  and  with  the  local 
Vayu  enraged  or  aggravated  by  the  incidental  bleeding, 
or  haemorrhage  will  occasion  excruciating  pain.  Potions 
of  Sneha  (oily  or  fatty  liquids)  and  using  the  same  as  a 
washing  (in  a  lukewarm  state)  should  be  advised  in  such 
cases.  Preparation  of  Ves'avaras  and  other  Krisaras 
largely  mixed  with  oil  or  clarified  butter  should  be  used 
as  poultices  and  fomentations  with  the  Masha  pulse, 
etc.,  and  the  use  of  oily  ungents  and  emulsive  Yastis 
(enematas)*  prepared  with  decoctions  of  Vayu-subduing 
drugs  should  be  applied.  A  crushed  or  thrashed  wound 
or  abrasion  is  not  attended  wi:h  any  excessive  bleeding 
an  absolute  absence  whereof,  '^on  the  contrary)  gives  rise 
to  an  excessive  burning  sensation  and  suppuration  in 
the  affected  part.  Cold  washes  and  cooling  plasters 
should    be    used  in  these  cases  for  the  alleviation  of  the 

*  Snehapana  is  recommended  when  the  ulcer  is  in  a  region  above  the 
umbilicus  and  Vasti-karma  when  the  ulcer  is  in  a  subumbilical  region. 


268  THE   SUSHRUTA   SAMHITA.  [Chap.  IT, 

burning  and  suppuration  as  well  as  for  the  cooling  of 
the  (incarcerated)  heat.  What  has  been  specifically 
said  of  these  six  forms  of  ulcers,  or  wounds  should  be 
understood  to  include  the  treatment  of  all  kinds  of  trau- 
matic wounds  or  ulcers  as  well.     i8 — 20. 

Treatment  of  cuts  or  incised  wounds 

&C  : — Now  we  shall  discourse  on  the  medical  treatment 
of  Chhinna  cuts.  An  open  mouthed  ulcer  on  the  side 
of  the  head*  should  be  duly  sutured  as  described  before 
and  firmly  bandaged.  An  ear  severed  or  lopped  off 
should  be  sutured  in  the  proper  way  and  position  and 
oil  should  be  poured  into  its  cavity.  A  Chhinna  cut  on 
the  Krikatika  (lying  on  the  posterior  side  of  the  junction 
of  the  neck  and  the  head)  and  even  if  it  allow  the 
V^yu  t  (air)  to  escape  through  its  cavity  should  be 
brought  together  and  duly  sutured  and  bandaged  in  a 
manner  (so  as  not  to  leave  any  intervening  space 
between\  The  part  thus  adhesioned  should  be  sprinkled 
with  clarified  butter  prepared  from  goat's  milk.  The 
patient  should  be  made  to  take  his  food  lying  on  his 
back,  properly  secured  or  fastened  with  straps  (so  that  he 
might  not  move  his  head  and  advised  to  perform  all 
other  physical  acts  such  as,  urination,  defecation  etc ,  in 
that  position).     21-24 

In  the  case  of  a  lateral  and  wide-mouthed  wound 
(sword-cut,  etc.)  on  the  extremeties,  the  bone-joints 
should  be  duly  set  and  joined  together  as  instructed 
before  and  the  wound  should  be  sutured  and  speedily 
bandaged    in    the   manner    of  a    Vellitaka  bandage,   or 

*  Several  commentators  explain  those  that  are  situated  either  on  the 
head  or  on  the  sides. 

t  The  dictum  that  a  hurl  on  any  of  the  wind-carrying  sounding  chan- 
nels is  pronounced  to  be  incurable,  should  not  be  supposed  to  hold  good 
in  the  present  case. 


Chap.  II.]  CHIKITSA   STHANAM.  269 

with  a  piece  of  skin  or  hide  in  the  Gophana  or  such 
other  form  as  would  seem  proper  and  beneficial  and  oil 
should  be  poured  over  it.  In  the  case  of  a  wound  on 
the  back  the  patient  should  be  laid  on  his  back,  while  in 
the  case  of  its  occurring  on  the  chest  the  patient  should 
be  laid  on  his  face*     25-27. 

In  the  case  of  a  hand  or  a  leg  being  carried  away  or 
completely  severed  the  wound  should  be  cauterised  with 
the  application  of  hot  oil  and  bandaged  in  the  manner 
of  a  Kosha  bandage  and  proper  healing  medicines 
should  be  applied.  An  oil  cooked  with  the  eight  drugs 
Chandana,  Padmaka,  Rodhra,  Utpala,  Priyan^u,  Haridrd, 
Madhuka^  (Yasthimadhu)  and  milk,  forms  one  of  the 
most  efficacious  healing  (Ropana)  agents  A  Kalka  of 
the  thirteen  drugs  —  Chandana,  Karkatdkhya,  the  two 
kinds  of  Sahd  (Mugani  and  Mashani),  Mdnsi,  (D.R. — 
Mashahva,  Somahva),  Amritd,  Hatenu,  Mrindla 
Triphald^  Padmaka  and  Utpala  should  be  cooked  in 
oil  mixed  with  milk  (four  times  that  of  oil)  and  the  three 
other  kinds  of  oily  matter  (lard,  marrow  and  clarified 
butter)  and  this  medicated  oil  should  be  used  for 
sprinkling  over  a  wound  of  this  type  for  the  purpose  of 
healing  (Ropana).     28. 

IVIedical    Treatment    of     Bhinna  :— 

Henceforth  we  shall  deal  with  the  medical  treatment 
of  Bhinna  (excised)  wounds.  A  case  of  an  excised  eye 
(Bhinna)  should  be  given  up  as  incurable.  But  in 
the  case  where  an  eye  (ball)  instead  of  being  completely 
separated  would  be    found    to    be   dangling   out   (of  its 

*  For  the  complete  elimination  of  the  deranged  Dosha  i.e,^  pus,  eic  , 
of  the  wound    invloved  in  the  case — Jejjata. 

He  who  has  got  a  wound  on  his  back  should  be  laid  on  his  face  and 
he  who  has  got  an  ulcer  on  his  breast  should  be  laid  on  his  back — 
Dififereut  Reading  Gayi. 


2^0  THE  SUSHRUTA  SAMHITA.  [Chap.  It. 

socket)  the  affected  organ  should  be  re-instated  in  its 
natural  cavity  in  a  manner  so  as  not  to  disturb  the 
connected  Siras  (nerve  arrangements)  and  gently  pressed 
with  the  palms  of  the  hand  by  first  putting  a  lotus  leaf 
on  its  (eye)  surface.  After  that  the  eye  should  be  filled 
(^Tarpana)  with  the  following  (D.R,  -  Ajena  in  place  of 
'Anena' — i.e.,  prepared  from  goat's  milk)  medicated 
clarified  butter,  which  should  be  as  well  used  in  the 
form  of  an  errhine.  The  recipe  is  as  follows  : — Clarified 
butter  prepared  from  goat's  milk,  Madhuka,  Utpala, 
fivaka  and  Rishavaka  taken  in  equal  parts  should 
be  pasted  together,  and  cooked  with  sixteen  seers  of 
cow's  milk  and  four  seers  of  clarified  butter.*  The 
use  of  the  medicated  Ghrita  thus  prepared  should  be 
regarded  as  commendable  in  all  types  of  occular  hurt  or 
injury.     29. 

In  the  case  of  a  perforation  of  the  abdomen  marked 
by  the  discharge  of  lumps  or  rope-like  Varti  (fat) 
through  the  wound,  the  emitted  or  ejected  fat-lump 
should  be  dusted  with  the  burnt  ashes  (D.  R. -powders) 
of  astringent  woods  (such  as  Manu,  Arjuna,  etc.)  and 
black  clay  (pounded  together).  A  ligature  of  thread 
should  then  be  bouid  round  the  fat-lump  and  the  fat- 
lump  cut  off  with  a  heated  instrument.  Honey  should 
then  be  applied  and  the  wound  (Vrana)  should  then 
be  duly  bandaged.  The  patient  should  be  caused 
to  drink  clarified  butter  after  the  full  digestion  of  his 
injested    food.     Instead    of    this    Ghrita,  milk  prepared 

*  Several  authorities,  however,  say  that  equal  parts  of  clarified 
butter  prepared  from  goat's  milk  and  from  cow's  milk  should  be  taken  and 
cooked  with  l6  seers  of  cow's  milk  and  with  the  four  drugs  as  a  Kalka. 

Bui  Gayi  recommends  only  four  seers  of  clarified  butler  prepared  from 
goat's  milk  cooked  with  16  seers  of  cow's  milk  and  the  four  drugs  as 
a  Kalka. 


I 


Chap.  II.]  CHIKITSA   STHANAM .  27 1 

medicinally  with  Yashtimadchi,  Ldkshd  and  Gokshura^ 
mixed  with  (a  proper  quantity  of)  sugar  and  castor  oil 
(as  Prakshepa)*  is  equally  commendable  for  the  alle- 
viation of  the  pain  and  the  burning  sensation,  (in  the 
wound  or  ulcer).  The  fat-lump  (pariental  fat)  afore- 
said causes  a  rumbling  sound  with  pain  in  the  abdomen 
and  may  prove  even  fatal  in  the  event  of  its  being  left 
uncut.  The  medicated  oil  to  be  mentioned  hereafter 
in  connection  with  Medaja-Granthi  should  be  applied 
in  such  cases.     30-32 

Foreign  bodies  t^Salya)  piercing  into  any  of  the 
Koshthas  after  having  run  through  the  (seven  layers  of; 
skin,  whether  passing  through  the  veins,  etc  ^  (muscles, 
nerves,  bones  or  joints  or  not,  produces  the  distressing 
symptoms  described  before  (Ch.  III. — Sutra).  The  blood 
(of  the  affected  chamber  or  receptacle)  in  such  case  lies 
incarcerated  therein  in  the  event  of  its  failing  to  find  an 
outlet  and  causes  a  paUor  of  the  face  and  a  coldness  of  the 
extremities  and  of  the  face  in  the  patient.  Respiration 
becomes  cold,  the  eyes  red-coloured,  the  bowels  consti- 
pated and  the  abdomen  distended.  The  manifestation 
of  these  symptoms  indicates  the  incurable  character  of 
the  disease.     33-34. 

•  This  explanation  is  given  on  the  authority  of  old  Vagabhata. 
Dallana,  however,  explains  the  verse  in  a  different  way.  He  explains  it 
to  mean  two  different  preparations  of  milk— one  with  Yashti-madhu  and 
mixed  with  sugar  and  castor  oil  as  a  Prakshepa  and  the  other  with 
Gokshura  and  mixed  with  Laksha  and  castor  oil  as  a  Prakshepa. 

A  third  in'erprctation  would  make  three  preparations  of  milk  prepared 
separately  with  Yashti-madhu,  Laksha  and  Gok&hura — sugar  and  castor 
oil  being  mixed  in  the  first  (as  Prakshepa)  and  castor  oil  alone  in  the 
second  and  third. 

A  fourth  preparation  would  be  to  prepare  the  milk  separately  wiih 
Yasbtimadhu,  Laksha  and  Gokshura  as  in  the  preceding  case— without  the 
Addition  of  castor  oil  (as  Prakshepa), 


272  THE  SUSHRUTA  SAMHITA.  [C^ap.  II. 

Emesis  is  beneficial  in  the  case  where  the  blood 
would  be  found  to  be  confined  in  the  Am  as  ay  a 
(stomach).  Purgatives  should  unhesitatingly  be  pre- 
scribed where  the  blood  would  be  found  to  have  been 
lodged  in  the  Pakvas'aya  (intestines)  and  Asthapana 
measures  without  oil  should  be  employed  with  hot, 
purifying  i^Sodhana)  substances  (such  as  the  cow-urine, 
etc.)  The  patient  should  be  made  to  drink  a  Yavagu 
(gruel)  with  Saindhava  salt  and  his  diet  should  consist 
of  boiled  rice  mixed  with  the  soup  of  barley,  Kola  and 
Kulalttha  pulse  divested  of  oil.     35-36. 

In  a  case  of  a  perforation  or  piercing  of  any  of  the 
bodily  Koshthas  attended  with  excessive  haemorrhage 
or  bleeding,  the  patient  should  be  caused  to  drink  (a 
potion  of  animal)  blood  and  such  a  case  marked  by  the 
passage  of  stool,  urine,  etc.,  through  their  proper  channels 
of  outlet  and  by  the  absence  of  fever  and  tympanites 
and  other  dangerous  symptoms,  (Upadrava),  may  end 
in  the  ultimate  recovery  of  the  patient.     37-38. 

In  a  case  of  a  perforation  of  the  Koshtha  (abdomen) 
where  the  intestines  have  protruded  or  bulged  out  in  an 
untorn  condition,  they  should  be  gently  re-introduced 
into  the  cavity  and  placed  in  their  original  position, 
and  not  otherwise.  According  to  others,  however, 
large  black  ants  should  be  applied  even  to  the  perforat- 
ed intestines  in  such  a  case  and  their  bodies  should  be 
separated  from  their  heads  after  they  had  firmly  bitten 
the  perforated  parts  with  their  claws.  After  that  the 
intestines  with  the  heads  of  the  ants  attached  to  them 
should  be  gently  pushed  back  into  the  cavity  and  re- 
instated in  their  original  situation  therein.  The  bulged 
out  intestines  should  be  rinsed  with  grass,  blood  and 
dust,  washed  with  milk  and  lubricated  with  clari- 
fied butter  and  gently  re-introduced  into   the   cavity  of 


Chap.  II.]  CHIKiTSA  StHANAM.  ^^^ 

■  the  abdomen  with  the  hand  with  its  finger  nails  cleanly 
paired.  The  dried  intestines  should  be  washed  with  milk 
and  lubricated  with  clarified  butter  before  introducing 
it  into  their  former  and  natural  place  in  the  abdo- 
men.    39-41. 

In  a  case  where  the  intestines  could  be  but  partially 
introduced,  the  three  following  measures  should  be 
adopted.  The  interior  of  the  throat  of  the  patient 
should  be  gently  rubbed  with  a  finger  [and  the  urging 
for  vomiting  thus  engendered,  would  help  the  full 
introduction  of  the  intestines  into  the  abdominal  cavity]. 
As  an  alternative,  he  should  be  enlivened  with  sprays 
of  cold  water  ;  or  he  should  be  caught  hold  of  by  his 
hands  and  lifted  up  into  the  air  with  the  help  of  strong 
attendants  and  shaken  in  a  manner  that  would  bring 
about  a  complete  introduction  of  the  intestines  into 
the  natural  position  in  the  abdominal  cavity.  They 
should  be  so  introduced  as  to  press  upon  their  specific 
(Maladhara)  Kald  (facia).     42-43. 

In  a  case  where  the  re-introduction  of  the  intes- 
tines into  the  abdominal  cavity  would  be  found  to  be 
difficult  owing  to  the  narrowness  or  largeness  of  the 
orifice  of  the  wound,  it  should  be  extended  or  widened 
with  a  small  or  slight  incisiona  ccording  to  requirements, 
and  the  intestines  re-introduced  into  their  proper  place. 
The  orifice  or  mouth  of  the  wound  should  be  forthwith 
carefully  sutured  as  soon  as  the  intestines  would  be 
found  to  have  been  introduced  into  their  right  place. 
Intestines  dislodged  from  their  proper  seat,  or  not  intro- 
duced into  their  correct  position,  or  coiled  up  into  a 
lump  bring  on  death.     44-46. 

Subsequent  Treatment :  -[After  the  full 

and    correct   introduction    of   the  intestines]  the  wound 
should  be  bandaged  with  a  piece  of  silk-cloth    saturated 

35 


274  TtiE  SUSHRUTA  SAMHITA.  [Chap.  it. 

with  clarified  butter,  and  the  patient  should  be  given  a 
draught  of  tepid  clarified  butter  (D.  R.  tepid  milk)  with 
castor  oil  for  an  easy  passage  of  the  stool  and  downward 
coursing  of  the  Vdyu  (spontaneous  emission  of  the  flatus). 
Then,  for  its  healing  up  (Ropana),  a  medicated  oil,  pre- 
pared with  the  bark  of  the  Asvakarnay  Dhava,  S'dlmali, 
Mesha'S'ringi,  S'allaki^  Arjuna^  Viddri,  and  Kshiri  trees 
and  Vald  roots  should  be  applied  to  the  wound.  For  a 
year  the  patient  should  live  a  life  of  strictest  conticence 
and  forego  all  kinds  of  physical  exercise.     47 — 48. 

The  legs  and  the  eyes  of  the  patient  should  be 
washed  and  sprinkled  with  water  in  the  event  of  the 
bursting  out  of  the  testicles  which  should  be  intro- 
duced into  their  proper  place  within  the  scrotum,  and 
sewn  up  in  the  manner  of  a  Tunna-sevani  (raised  seam). 
The  scrotum  should  be  bandaged  in  the  shape  of  a 
Grophansb-Vandha  and  a  restraining  apparatus  (Ghatta- 
Yantra)  placed  round  the  waist  of  the  patient  (to 
guard  it  against  its  oscillations  or  hanging  down).  The 
wound  should  not  be  lubricated  with  any  kind  of 
oil  or  Ghrita  inasmuch  as  it  would  make  the  wound 
moist  and  slimy.  The  wound  should  be  healed  with  a 
medicated  oil  prepared  with  Kdldmisdri,  Aguru^  Eld, 
Jdti  flower,  Chandana,  Padmaka,  Manahs'ild,  Devaddru, 
Amrita  and  sulphate  of  copper  (pounded  together).  49-50. 

A  plug  of  hair  should  be  inserted  into  a  wound  on 
the  head,  after  having  extracted  the  foreign  matter 
therefrom,  with  a  view  to  arrest  the  exuding  of  the 
brain  matter  (Mastulunga)  which  invariably  proves  fatal 
to  the  patient  through  the  aggravation  of  the  deranged 
Vayii  in  consequence  thereof.  The  hairs  of  the  plug 
should  be  taken  out  one  by  one  as  the  healing  process 
progresses  (granulation).  An  oleaginous  medicated  plug 
or  lint  should  be  inserted  into    a   wound    on    any   other 


i 


Chap.  II.]  CHIKITSA   STHANAM.  275 

part  of  the  body,  which  should  be  treated  with  the 
measures  and  remedial  agents  laid  down  in  connection 
with  a  traumatic  ulcer  after  having  first  allowed  the 
vitiated  blood  to  escape.     51-52. 

The  medicated  oil  known  as  the  Chakra-taila* 
should  be  poured  (frequently  applied)  by  means  of  a 
slender  pipe  into  an  ulcer  (wound)  which  is  deep-seated 
but  narrow-mouthed,  after  first  letting  out  the  vitiated 
bloodf.  An  oil  duly  prepared  and  boiled  with  Samangd, 
Haridtd,  Padmdy  TriiargaX  Tuttha,  Vidanga,  Katuka, 
Pathydy  Guduchi  and  Karanja  acts  as  a  good  healing 
(Ropana)  agent  (in  these  cases).  The  use  of  an  oil 
prepared  with  Tdlis'a,  Padmaka,  Mdnsi,  Harenu^  Aguru^ 
Chandana^  and  the  two  kinds  of  Haridrd,  Padma-vijuy 
Us'ira  and  Yashti-madhu  acts  as  a  good  healing  remedy 
in  cases  of  traumatic  ulcers.     53-55- 

A  cut  wound  (Kshata)  should  be  treated  with  its 
own  specific  measures  and  remedies,  while  a  bruised 
one  (Pichchita)  should  be  treated  (to  all  intents  and 
purposes)  as  a  case  of  Bhagna  (bone-fracture).  The  first 
treatment  of  a  mangled  or  contused  wound  (G-hrishta) 
is  to  extinguish  pain,  after  which  it  should  be  dusted 
with  the  powder  of  proper  medicinal  drugs  (such  as 
S'dla,  Sarja,  Arjuna,  etc.).     56' 57. 

In  the  case  of  a  dislocation  of  any  part  of  the  body, 
caused  by  a  fall  (from  a  tree),  or  in  the  event  of  having 
been  run  over  or  trampled  down  (Mathita — by  a  carriage 
or  by  a  beast),    or  of  being   wounded  (by  a    blow,   etc.), 

*  The  oil  just  pressed  out  of  an  old  oil-miil  or  squeezed  out  of  the 
chips  of  wood  belonging  to  an  old  one,  in  the  manner  of  the  Anutaila 
to  be  described  hereafter,  is  called  the  Ohakra-taxla 

t  The  vitiated  blood  should  first  be  lei  out  for  fear  of  putrefaction 
of  the  ulcer. 

:;:    Triphala,  Trikatu  and  Trimada  are  called  Trivarga. 


276  THE  SUSHRUTA   SAMHITA.  [Chap.  II. 

the  patient  should  be  kept  immersed  in  a  large  tank 
(Droni)  of  oil  and  the  diet  should  consist  of  the  soup  or 
essence  (Rasa)  of  meat.  A  man  fatigued  (from  the 
labours  of  a  journey),  or  hurt  at  any  of  the  Marmas, 
should  be  likewise  treated  with  the  preceding 
measures.     58. 

Oil  or  clarified  butter  should  be  always  administered 
as  drinks,  washes  or  external  healing  applications  for  an 
ulcer-patient  with  a  due  regard  to  his  temperament  and 
the  nature  of  the  season.  Medicated  Ghritas,  yet  to  be 
mentioned  in  connection  with  the  medical  treatment  of 
a  Pittaja  abscess,  should  be  used  as  well  in  the  case  of 
a  traumatic  ulcer  (according  to  its  respective  indica- 
tions). A  physician  should  wash  a  traumatic  ulcer 
attended  with  an  aching  pain  either  with  a  Vala-oil  or 
tepid  clarified  butter  (according  to  the  nature  of  the 
season  and  the  temperament  of  the  patient).*     59 — 61. 

An  oil  codk^dvilthSamangd^Rajani,  Padmd{fih.-krg{), 
Pathyd,  sulphate  of  copper,  Suvarchald,  Pad^naka, 
Lodhra,  Yashti-madhuka,  Vidanga,  Harenuka,  Tdlisa- 
patra^  Nalada  (fatdmdnsi),  (red)  Chandana,  Padma- 
kes'ara^  Manjishthd,  Usira^  Ldkshd,  and  the  tender 
leaves  of  Kshiri  trees,  Piydla  seeds,  raw  and  tender 
Tinduka  fruit,  or  with  as  many  of  them  as  would  be 
available,  should  be  regarded  as  a  good  healing  remedy 
in  respect  of  all  non- malignant  traumatic  sores  or  ulcers. 
Applications  of  astringent,  sweet,  cooling  and  oily 
medicines  should  be  used  for  a  week  in  a  case  of  a 
traumatic  ulcer  (Sadyo-vrana),  after  which  those  men- 
tioned before,  in  the  Chapter  of  Divraniya,  should  be 
adopted.     62—63. 

*  With  oil  in  autumn  and  in  the  case  of  a  patient  of  Rakta-pitta 
temperament,  and  wi»h  Vala-oil  in  winter  and  in  the  case  of  one  of  a  Vata- 
kapha  temperament. 


Chap.  II.]  CHIKITSA   STHANAM.  277 

Treatment  of  Dushta-Vrana:— In  the 

case  of  a  malignant  ulcer  (Dushta-Vrana)  emetics, 
errhines,  purgatives,  Asthapana,  fasting,  specific  sorts 
of  diet  (composed  of  bitter,  pungent  and  astringent 
things)  and  blood-letting,  should  be  prescribed  (accord- 
ing to  the  requirements  of  each  case).  The  ulcer  or 
sore  should  be  washed  with  the  decoctions  of  the 
drugs  of  both  the  Aragvadhddi  and  the  Surasddi  ganas, 
and  an  oil  cooked  with  a  decoction  of  the  said 
drugs  should  be  applied  to  the  wound  for  |the 
purification  (Sodhana)  thereof.  As  an  alternative,  an  oil 
boiled  and  prepared  in  an  alkaline  water  or  solution 
(four  times  that  of  oil)  with  a  Kalka  of  alkaline  subs- 
tances (such  as  Ghantdparuli,  Palas'a,  etc.)  should  be 
used  for  that  end.  Oil  cooked  with  Dravanti 
(Satamuli,  according  to  certain  authorities,  Mushika- 
parni  according  to  others),  Chiravilva^  Dantiy  Chit- 
raka,  Prithvikd  Nimba-leaves ,  Kdsisa^  Tuttha^  Trivrit, 
Tejovaii,  Nili  (indigo),  the  two  kinds  of  Haridrd, 
Saindhava  salt,  Tila,  Bhumi-Kadamba^  Suvahd,  S'ukd- 
khyd,  Ldngaldkvd,  Naipdli^  Jdlini,  Madayanti^ 
Mrigddani,  Sudhd^  Murvd,  Arka,  Kitdri,  Haritdla^ 
and  Karanja,  or  with  as  many  of  them  as  would  be 
available,  should  be  used  for  the  purification  (of  a  malig- 
nant sore  or  ulcer).  If  found  applicable,  a  medicated 
Ghrita  prepared  and  cooked  with  the  foregoing  drugs 
and  substances  as  Kalka  should  be  used  for  the  same 
purpose.  In  the  case  of  a  malignant  ulcer,  due  to  the 
aggravated  Vayu,  the  purifying  remedy  should  consist 
of  a  Kalka  of  Saindhava  salt,  Trivrit  and  castor  leaves. 
In  the  case  of  a  (malignant)  Pittaja  sore,  the  remedy 
should  consist  of  a  Kalka  of  Trivrit,  Haridrd,  Yashti- 
madhu  and  Tila.  In  the  case  of  a  malignant  ulcer, 
caused  by  the  aggravated  Kapha,  the  purifying  remedial 


278  THE  SUSHRUTA    SAMHITA.  [Chap.  II. 

agent  should  consist  of  Tila,  Tejohvd,  Danti,  Svarjikd 
and  Chitraka  roots.  An  ulcer  brought  on  owing  to  the 
presence  of  the  virus  of  Meha  or  Kushtha  in  the  system, 
measures  and  remedies  mentioned  under  the  treatment 
of  Dushta-vrana  should  be  adopted  and  used.     64 — 68. 

The  recognised  school  of  physicians,  which  recognises 
these  six  types  of  traumatic  sores,  does  not  add  to  the 
list,  herein  mentioned,  other  types  of  ulcers,  whereas 
vain  pedagogues  try  to  swell  it  with  a  larger  number  of 
types  by  adding  connotative  prefixes  and  suffixes  to  the 
names  of  the  aforesaid  six.  It  is  mere  vain-gloriousness 
on  their  part  to  say  so,  since  all  the  other  types  that 
they  can  devise  are  but  single  instances  and  can  be  made 
to  fall  under  one  of  these  six  general  heads.  Hence 
there  should  be  only  six  kinds  (of  traumatic  sores)  and 
not  more.     69. 

Thus  ends  the  second  Chapter  of  the  Chikitsita  Sthanam  of  the  Sus'ruta 
Samhita  which  deals  with  the  treatment  of  Sadyo-vrana  (traumatic  sores). 


CHAPTER  III. 

Now  we  shall    discourse  on    the  medical  treatments 
of  fractures  and  dislocations  (BhagTiaS).  i. 

Metrical  Texts  :— A  fracture  or  dislocation 
(Bhagna)  occurring  in  a  person  of  a  Vatika  tempera- 
ment, or  of  intemperate  habits,  or  in  one  who  is  sparing 
in  his  diet,  or  is  affected  with  such  supervening  disorders 
(as  fever,  tympanites,  suppression  of  the  stool  and  urine, 
&c.)  is  hard  to  cure.*  A  fracture-patient  must  forego 
the  use  of  salt,  acid,  pungent  and  alkaline  substances 
and  must  live  a  life  of  strictest  continence,  avoid  expo- 
sure to  the  sun  and  forego  physical  exercises  andparchi-. 
fying  (devoid  of  oleaginous)  articles  of  food.  A  diet 
consisting  of  boiled  rice,  meat-soup,  milk,  f  clarified 
butter,  soup  of  Satina  pulse  and  all  other  nutritive  and 
constructive  food  and  drink,  should  be  discriminately 
given  to  a  fracture-patient.  The  barks  of  Udumbara, 
Madhuka,  As'vattha,  Palds'a,  Kakuhha^  Bamboo^  Vata 
or  Sdla  trees  should  be  used  as  splints  (Kusa).  Manji- 
shthd,  Madhuka,  red  sandal  wood  and  Sdli-ricQ  mixed 
with  S'ata-Dhauta   clarified  butter  (i.e.,   clarified   butter 

*  Jejjata  does  not  read  the  first  verse,  but  Gayi  does. 

t  As  a  general  rule,  milk  should  not  be  prescribed  to  a  patient 
suffering  from  an  ulcer  (Vrana)  in  general  ;  but  a  case  of  fracture  forms 
an  exception  thereto.  Some  authorities  hold  that  tepid  milk  may  be 
given  to  a  fracture-patient,  if  there  be  no  ulcer  (Vrana).  Others,  on  the 
contrary,  are  of  opinion  that  milk  should  not,  in  any  case,  be  given  to  a 
fracturc'patient  for  fear  of  suppuration  and  the  setting  in  of  pus. 

Others,  however,  take  "Kshirasarpih"  to  be  a  compound  word  and 
explain  the  term  to  mean  the  clarified  butter  prepared  from  milk  (as 
distinguished  from  that  prepared  from  curd). 

But  experience  tells  us  that  in  cases  of  excessive  weakness  or  emacia- 
tion, milk  may  be  given  without  any  hesitation— Ed. 


28o  THE  SUSHRUTA  SAMHITA-  [Chap.  lit. 

washed  one  hundred  times  in  succession)  should  be  used 
for  plastering  the  fracture.     2-6. 

Bandag'e  : — Fractures  should  be  (dressed  and) 
bandaged  once  a  week  in  cold  weather,  on  every  fifth 
day  in  temperate  weather  {i.e.,  in  spring  and  autumn), 
and  on  every  fourth  day  in  hot  weather  {t.e.,  in  summer), 
or  the  interval  of  the  period  for  bandaging  should  be 
determined  by  the  intensity  of  the  Doshas  involved  in 
each  individual  case.  An  extremely  loose  bandage 
prevents  the  firm  adhesion  of  a  fractured  bone,  a  light 
bandage  gives  rise  to  pain,  swelling  and  suppuration 
of  the  local  skin,  &c.  Hence  in  cases  of  fractures, 
experts  prefer  a  bandage  which  is  neither  too  tight  nor 
too  loose.     7-Z, 

Washings  :— A  cold  decoction  of  the  drugs  of 
the  Nyagrodhddi  group  should  be  used  in  washing  (the 
affected  part),  whereas  in  the  presence  of  (excessive) 
pain,  (the  part)  should  be  washed  with  milk  boiled  with 
the  drugs  of  the  (minor)  Pancha-mula,  or  simply  with  the 
oil  known  as  the  Chakra-taila  made  lukewarm*.  Cold  (or 
warm)  lotions  and  medicinal  plasters  (Pradehas)ofDosha- 
subduing  drugs  should  be  prescribed  with  due  regard  to 
the  nature  of  the  season  and  the  Doshas  involved  in 
each  case.     9-10. 

A  preparation  of  milk  f  from  a  cow,  delivered  for  the 
first  time,  boiled  with  the  drugs  of  the  Madhurddi  group 
and  mixed  with  powdered  shellac  and  clarified  butter  (as 
an  afterthrow)  should  be  given  (when  cold)  to  a  fracture- 
patient   as   a   beverage    every    morning.     In   a    case  of 

*  In  winter  and  where  the  aching  pain  is  present  due  to  Vayu  and 
Kapha. 

t  Consisting  of  the  drugs  of  the  Kakolyadi  group  weighing  two  Tolas, 
milk  sixteen  Tolas,  water  sixty-four  Tolas,  boiled  together  with  the  water 
entirely  evaporated. 


Ghap.    III.]  CHIKITSA  STHANAM.  2^1 

fracture  attended  with  ulcer  on  the  part,  an  astringent 
plaster  plentifully  mixed  with  honey  and  clarified  butter 
should  be  applied  ;  and  the  rest  (diet  and  regimen  of 
conduct)  should  be  as  laid  down  in  the  case  of  a  (simple) 
fracture.      11-12. 

PrOgTIO^iS  :  -A  case  of  fracture  occurring  in  a 
youth  or  a  person  with  slightly  deranged  Doshas  or  in 
winter,  is  held  to  b3  easily  curable  (with  the  help  of  the 
aforesaid  medicines  and  diet).  A  fractured  bone  in  a 
youth  is  joined  by  the  aforesaid  treatment  in  the  course 
of  a  month,  in  two  months  in  the  case  of  a  middle- 
aged  man  and  in  three  months  in  one  of  old  age.     13-14. 

An  elevated  and  fractured  joint  should  be  reduced  by 
pressing  it  down,  while  one  hanging  down  should  be 
set  by  raising  it  up,  by  pulling  it  in  the  case  of  its 
being  pushed  aude,  and  by  reinstating  it  in  its  upward 
(proper)  position  in  the  event  of  its  being  lowered  down. 
An  intelligent  physician  should  set  all  dislocated  (Bhagna) 
joints,  whether  fixed  or  movable,  by  the  mode  of 
reduction,  known  as  Anchhana,  Pidana,  (pressure), 
Sankshepa  and  Vandhana  (bandaging).     15-16. 

Treatment  :— A  crushed  or  dislocated  joint 
should  not  be  shaken  (/.6'.,  should  be  kept  at  rest)  and 
cold  lotions  or  washes  and  medicated  plasters  (Pradeha) 
should  be  applied  to  the  part.  A  joint  is  spontaneously 
reset  to  its  natural  or  normal  state  or  position  after  the 
correction  of  its  deformity  incidental  to  a  blow  or  hurt 
having  been  effected.  The  fractured  or  dislocated  part 
should  be  first  covered  with  a  piece  of  linen  soaked  in 
clarified  butter.  Splint  should  then  be  placed  over  it 
and  the  part  properly  bandaged.     17-19. 

Treatment  of  fractures  in  particular 

limbs  : — Now  we  shall  discourse  on  the  measures   to 
be    adopted    in    fractures   occurring   in    each   particular 

36 


282  THE  SUSHRUTA   SAMHITA.  [Chap.  HI. 

limb.     In  the  case  of  a   nail-joint,   being   in    any  way- 
crushed  or  swollen  by  the  accumulation  of  the  deranged 
blood  (in  the  locality),  the  incarcerated  blood  should    be 
first  let  out  with  the  help  of  an  awl  (Ard)   and    the   part 
should  be  plastered  with  a  paste  of  S^li-rice.    A  finger  or 
phalanx  bone  put  out  of  joint  or  fractured  should  be  first 
set  in  its  natural  position  and  bandaged  with  a  piece    of 
thin    linen    and   should   be   then   sprinkled    over   with 
clarified  butter.     In  the  case  of  a  fracture  in  the  foot  the 
fractured  part  should    be  first  lubricated    with    clarified 
butter,  then  duly  splinted  up,  and  bandaged   with   linen. 
Such  a  patient  should  forego    all    kinds    of  locomotion. 
In  the  case  of  a  fracture  of  the  knee-joint  or  thigh-bone 
the   affected   part   should    be   lubricated    with    clarified 
butter  and  carefully  pulled  straight,  after  which  it  should 
be  splinted  with  barks   (of  Nyagrodha,  etc.)   and  band- 
aged with  clean  linen.     In  case  of  the  fracture  projecting 
out   a   thigh-bone   should   be   reset  with  the  help  of  a 
circular   splint   and  bandaged.     In  the  case  of  Sphutita 
(cracked)   or    Pichchita   (bruised)    thigh-bone,   the   part 
should  be  also  bandaged  in  the  aforesaid  manner.   20-24. 
In  a  case  of  a  fracture  in   the   Kati   (Ilium-bone),   it 
should   be   reduced    by   the   fractured  bone  being  raised 
up  or  pressed  down  (as  the  case  may  be)  and  the  patient 
should  then  be  treated  with  Vasti  (enematas  of  medicated 
oils   or   Ghritas*;.     In    the   case   of  a   fracture   of  one 
of  the  rib-bones  (Parsaka),  the  patient  should    be   lubri- 
cated with  clarified  butter.     He  should    then    be   lifted 
up  (in  a  standing  posture)  and  the  fractured    rib   (bone), 
whether  left  or  right,  should  be   relaxed  by  being  rubbed 
with     clarified     butter.     Strips     of    bamboo     or     pad 

*  In  the  Niddna-Sthana—Chap.  XV.,  9— it  is  stated  that  a  case  of 
fracture  in  the  Kati  should  be  given  up  (Varjjayet).  Jejjata,  however, 
explains  "Varjjayel"  as  "hard  to  cure." 


Chap.  III.]  CHIKITSA  STHANAM.  283 

(Kavalikaj  should  b3  placed  over  it  and  the  patient 
should  be  carefully  laid  in  a  tank  or  cauldron  full  of 
oil  with  the  bamboo  splint  duly  tied  up  with  straps 
of  hide.  In  the  case  of  a  dislocation  of  the  Amsa- 
Sandhi  (shoulder-joint),  the  region  of  the  Kaksha 
(arm-pit)  should  be  raised  up  with  an  iron-rod  (Mushala) 
and  the  wise  physician  should  bandage  the  part,  thus 
reduced,  in  the  shape  of  a  Svastika  (8-shaped)  bandage. 
A  dislocated  elbow-joint  should  be  first  rubbed  with 
the  thumb,  after  which  it  should  be  pressed  with  a  view 
to  set  it  in  its  right  place  by  fixing  and  expanding  the 
same.  After  that  the  affected  part  should  be  sprinkled 
over  with  any  oleaginous  substance.  The  same  measures 
should  be  adopted  in  the  case  of  a  dislocation  of 
the  knee-joint  (Janu-sandhi),  the  wrist-joint  (Gulpha- 
sandhi)  and  the  ankle-joint  (Mani-vandha).     25-29. 

In  the  case  of  fractured  bones  in  the  palms  of  the 
hands,  the  two  palms*  should  be  made  even  and  opposed, 
and  then  bandaged  together  and  the  affected  parts  should 
be  sprinkled  with  raw  and  unmedicated  oil  (Ama-taila). 
The  patient  should  be  made  later  first  to  hold  a  ball  of 
cow-dung,  then  a  ball  of  clay  and  then  a  piece  of  stone 
in  his  palms  and  so  on,  with  the  progressive  return  of 
strength  (to  the  affected  parts).  In  a  case  of  a  fracture  of 
the  Akshaka,  the  affected  part  should  be  first  fomented 
and  then  reduced  by  raising  it  up  with  a  Mushala 
(iron-rod)  in  the  arm-pit  or  by  pressing  it  down  (as  the 
case  may  be)  and  should  be  firmly  bandaged.  A  case 
of  fractured  arm-bone  should  be  treated  according 
to  the  directions  given  in  the  case  of  a  fractured 
thigh-bone.     30-32. 

*  The  text  has  ''Ubhe  tale  same  kritvd.''  Jejjata  explains  "Ubhe  tale" 
to  mean  "palms  of  the  hands  and  soles  of  the  feet  j"  Gaya  Dasa  explains 
it  to  mean  "the  palms  of  both  the  bands." 


284  THE   SUSHRUTA  SAMHITA.  [Chap.  HE. 

Iiith3cas3of  a  banding    (twisting)  or    intussuscep- 
tion of  the  neck  downward,  the  head  should  be  lifted  up 
by  putting  the  fingers  into  the  hollow  (Avatu)  above  the 
nape  of  the  neck  and  at  the  roots  of  the  jaw-bones  (Hanu;*. 
Then  the  part  should  be  bandaged  with  a  piece    of  linen 
after  having  evenly  put  the  splint  (Kusa  round  the  neck). 
The   patient   should    be   caused  to  lie  constantly  on  his 
back  for  a  week.     In  a  case  of  a  dislocation  of  the  joints 
of  the  jaw-bones  (Hanu\  the  jaw-bones  should  be  foment- 
ed  and   duly  set  in  their  right  position,  bandaged  in  the 
manner   of  a    Panchangi-vandha,    and    a  Ghrita  boiled 
and    prepared   with   (the   Kalka  and  a  decoction  of)  the 
Madhura    (Kdkolyadi)    and    Vdyu-subduing    (Chavy^di) 
groups  should  be  used  as  errhines  by  the  patient.     33-3  ^ 
A  tooth  of  a  young    person,    not    broken    but    loose, 
should  be  plastered  with  a  cooling  paste  on    its    outside 
after  having  pressed  out  the   accumulated    blood    at   the 
root.     The  tooth  should    be    sprinkled    or   washed    with 
cold  water  and  treated    with   drugs   having  Sandhdniya 
(adhesive)  properties  f     The  patient   should   be   caused 
to    drink    milk   with   the   help   of  a   lotus   stem.     The 
loose  tooth  of  an  old    man    should    be   drawn.     A   nose 
sunk   down   or   depressed    (by   a  blow)  should  be  raised 
up  with  the  help  of  a  rod  or   director,   while    it   should 
be  straightened     in    a   case    of  simple    bending.     Then 
two  tubes,  open  at    both   ends,    should    be    inserted  into 
the   nostrils    (to    facilitate    the    process     of    breathing) 
and  the  organ  should  be  bandaged    and    sprinkled    with 
clarified    butter.     In  the  case   of  (the  cartilage  of)  the 
ear   being   broken,   the    organ    should    be  rubbed    with 

*  According  to  Gayi,  the  lifting  up  of  the  head  by  putting  fingers  in 
ihe  Avatu  and  in  the  Hanus  should  be  made  in  cases  of  bending  and 
intussusception  of  the  neck  respectively. 

t    Honey,  clarified  butter,  and  drugs  of  the  Nyagrodhddi  group. 


Chap.  III.]  CHTKITSA  STIIANAM,  285 

clarified  butter  straightened,  and  evenly  set  in  its 
right  position  and  bandaged.  Measures  and  remedial 
agents  mentioned  in  connection  with  Sadyo-vrana, 
should  be  likewise  adopted  and  employed  in  the  present 
instance.     37. 

In  a  case  of  a  fracture  of  the  bone  of  the  forehead 
unattended  by  any  oozing  out  of  brain  matter,  the 
affected  part  should  be  simply  rubbed  with  honey  and 
clarified  butter  and  then  duly  bandaged.  The  patient 
should  take  clarified  butter  for  a  week  *     38. 

Cooling  plasters  and  washes  should  be  applied  to  a 
part  of  the  body,  swollen  but  not  in  any  way  ulcerated 
on  account  of  a  fall  or  a  blow.  In  the  case  of  a  fracture 
of  the  bone  in  the  leg  and  in  the  thigh,  the  patient  should 
be  laid  down  on  a  plank  or  board  and  bound  to  five 
stakes  or  pegs  in  five  different  places  for  the  purpose 
of  preventing  any  movements  of  his  limbs.  The 
distribution  of  the  (bindings)  pegs  in  each  case  should  be 
as  follows.  In  the  first  case  (fractured  leg-bone),  two  on 
each  side  of  the  two  thighs  making  four  and  one  on  the 
exterior  side  of  the  enguinal  region  of  the  affected  side. 
In  the  second  case  (fracture  of  knee-joint)  two  on  each 
side  of  the  ankle-joints  making  four  and  one  on  the  side 
of  the  sole  of  the  affected  leg.  The  same  sort  of  bed  and 
fastenings  should  be  used  in  cases  of  fractures  and 
dislocations  of  the  pelvic-joint,  the  spinal  colnma,  the 
chest  and  the  shouldersf.  In  cases  of  long-standing 
dislocations,  the  joint  should  be  lubricated  with  oily  or 
lardaceous    applications,   fomented    and    softened    (with 

*  In  the  case  of  such  an  emission  or  oozing  out  a  plug  of  bristles  or 
hiir  as  described  in  the  preceding  chapter  and  remedial  agents  laid  down 
in  conneclion  therewith,  should   be    used. 

t  The  principle  of  splintering  and  bandaging  may  be  profitably 
compared  with  those  followed  in  Agnur's  splint. 


286  THE  SUSHRUTA  SAMHITA.  [Chap.  III. 

proper  medicinal  drugs)  in  the  manner  mentioned  above 
in  order  to  reduce  it  to  its  natural  state.     39-40. 

In  the  case  of  a  faulty  union  of  a  (fractured)  bone 
lying  between  two  joints  (Ka^ada-bhagna^,  the  union 
should  be  again  disjointed,  and  the  fractured  bone  should 
again  be  set  right  and  treated  as  a  case  of  ordinary 
fracture.  In  the  case  where  a  fractured  bone  would  be 
found  to  have  protruded  out  of  the  ulcerated  part  and 
dried,  it  should  be  carefully  cut  off  near  the  margin  of 
the  (incidental)  ulcer,  (so  as  not  to  create  a  fresh  ulcer  on 
any  other  spot  of  the  affected  part)  and  subsequently 
treated  as  a  case  of  fractural  ulcer.  A  fracture  occurring 
in  the  upper  part  of  the  body  should  be  treated  with 
applications  of  Mastikya-Sirovasti  [oil-soaked  pads  on 
the  head]  and  pourings  of  oil  into  the  cavity  of  the  ears. 
Potions  of  clarified  butter,*  errhines  and  Anuvasana 
(enematas)  should  be  prescribed  in  cases  of  fractures  in 
the  extremeties.     41-43. 

Gandha'-Taila  ;— Now  we  shall  discourse  on 
the  recipe  of  a  medicated  oil,  capable  of  bringing 
about  the  union  of  fractured  bones.  A  quantity  of  black 
sesamum-seeds  (tied  up  into  a  knot  with  a  piece  of  linen) 
should  be  kept  immersed  at  night  in  a  stream  of  running 
water  and  taken  out  and  dried  in  the  sun  (for  seven  conse- 
cutive days).  It  should  then  be  saturated  with  cow's  milk 
(at  night  and  dried  in  the  sun,  during  the  second  week). 
During  the  third  week  the  sesamum-seeds  should  be 
saturated  with  a  decoction  of  Yashti-madhu  (at  night) 
and  dried  in  the  sun  the  next  day.  Then  (during 
the  fourth  week)  it  should  be  again  saturated  with  cow's 
milk    and   dried   and    powdered.     The    said   sesamum- 

*  According  to  Jejjata,  not. only  Anuvds;ina-enematas  but  potions  of 
clarified  butter  and  errhines  also  should  be  prescribed  in  cases  of  fractures 
in  the  extremeties* 


Chap.  Hi.]  CHIKITSA  STHANAM.  287 

powder  and  powder  of  the  drugs,  constituting  the 
Kdkolyddi  Gana  as  well  as  Yasthi-madhu^  Manjishthd, 
Sdrivd,  Kushtha,  Sarja-rasa^  Mdnsi,  Deva-ddru,  (red) 
Chandana^  and  S'atapushpd  should  be  mixed  together. 
Then  a  quantity  of  cow's  milk  boiled  with  the  aromatic 
drugs  (of  the  Eladi  group)  should  be  used  with  the  pre- 
ceding pulverised  compound  for  the  purpose  of  pressing 
out  the  oil  therefrom.  The  oil  thus  pressed  out"  should 
be  boiled  in  four  times  the  quantity  of  cow's  milk  with 
the  drugs  such  as  Eld^  S'dlparni,  Tejapatra,  Jivaka, 
Tagara,  Rodhra^  Prapaundarika^  Kdldnusdri,  (Tagara), 
Saireyaka,  Kshira-Viddri,  Anantd,  Madhulikd,  S'ringd- 
taka^  and  those  of  the  aforesaid  list  (Kdkolyddi  group 
and  Yasthi-madhu^  etc.,  up  to  S'atapushpd)  pasted 
together.  The  oil  should  be  duly  cooked  over  a 
gentle  fire  and  is  called  the  Gandha-Taila.  This  oil 
should  be  administered  with  good  results  in  possible 
ways  (e.g.,  as  potions,  liniments,  unguents  and  errhines) 
to  a  fracture-patient.  Its  efficacy  is  witnessed  in  cases 
of  convulsions,  hemiplegia,  parchedness  or  atrophy  of 
the  palate,  in  Ardita  (facial  paralysis)  as  well  as  in 
Manyd-stambha  (Paralysis  or  stiffness  of  the  neck), 
in  diseases  of  the  head  (cephalagia),  in  ear-ache  in 
Hanu-graha,  in  deafness  and  in  blindness  and  in 
emaciation  due  to  sexual  excesses.  Administered  in 
food  or  drink,  or  employed  as  a  liniment,  in  Vasti-karma 
(enemata  measures)  or  as  an  errhine,  it  acts  as  a 
sovereign  restorative.  Rubbed  over  the  neck,  chest 
and  shoulders,  it  adds  to  the  strength  and  expansion 
of  those  parts  of  the  body,  makes  the  face  fair  and 
lovely   like   a   full-blown     lotus   and    imparts   a   sweet 

*  There  should  be  three  parts  of  sesamum  powder  and  one  part  of 
the  powders  of  Kakolyadi,  Yashti-madhu,  ManjUhthd,  etc.  (combined). 
But  siva  Dksa  says  that  four  parts  of  sesamum-powders  should  be  taken. 


288  THE   SUSHRUTA   SAMHITA.  [Chap.  III. 

fragrance  to  the  breath.  It  is  one  of  the  most  powerful 
Remedial  agents  in  disorders  of  the  aggravated  V^yu 
(diseases  of  the  nervous  system).  It  may  be  used 
even  by  kings  and  for  them  it  should  be  specially 
prepared.     44-45. 

The  expressed  oil  of  the  seeds  of  the  Trapusha, 
Aksha  and  Piydla  should  be  cooked  with  a  decoction  of 
drugs  of  the  Madhura  group  (Kakolyadi  gana)  and  with 
ten  times  the  quantity  of  milk.  A  quantity  of  lard  if 
available,  should  be  poured  into  it  (during  the  process  of 
cooking).  It  is  an  excellent  medicated  oil  and  used  as 
a  potion  for  anointing,  and  as  an  errhine,  Vasti-karma 
and  washes,  it  speedily  brings  about  the  union  of 
fractured  bones.     46. 

A  physician  should  exert  his  utmost  to  guard  against 
the  advent  of  any  suppurative  setting  in  in  a  fractured 
bone,  since  a  suppuration  of  the  local  veins,  nerves  and 
muscles  is  difficult  to  cure.  A  complete  union  of  a 
fractured  joint  should  be  inferred  from  its  painless  or 
unhurt  character,  from  its  full  and  perfect  development 
(leaving  no  detectable  signs  of  its  once  fractured  con- 
dition)j  from  the  absence  of  all  elevation  (unevenness) 
and  from  its  perfect  freedom  in  flexion  and  expansion, 
etc.     47-48. 

Thus  ends  the  third  Chapter  of  the  Chikitsita  Sihanani  in  the  Sua'ruta 
Sanihila  which  deals  with  the  medical  treatment  of  fractures  and  dis- 
locations. 


CHAPTER  IV. 

Now  we  shall  discourse  on  the  medical  treatment  of 
nervous  disorders  (Vata-vyadhi).      i. 

IVIetrical  Texts  ; — The  patient  having  been 
made  to  vomit  in  the  event  of  the  deranged  Vayu  being 
incarcerated  (lodged)  in  the  Amais'aya  (stomach),  a 
pulverised  compound  known  as  the  Shad-Dharana-yoga 
(a  compound  of  six  Dharanas  or  twenty-four  Mash^ 
weight)  with  tepid  water  should  be  administered  to  him 
for  seven  days.  A  compound  made  up  of  Chitraka, 
Indra-yava^  Pdthd,  Katuka^  Ativishd,  Abhayd  (taken 
in  equal  parts)  together  is  known  as  the  Shad- 
Dharana-yoga*  and  contains  the  properties  of  sub- 
duing an  attack  of  Vdta-vyadhi.     2-3. 

In  the  event  of  the  aggravated  Va}  u  being  incar- 
cerated in  the  Pakvsts'aya  intestines),  purgatives  of  fatty 
matters  (Sneha-Virechana,  i.e  ,Tilvaka-Sarpih,ctc.),  and 
Sodhana-  Vasti  of  purifying  drugs  (with  decoctions  and 
Kalka  of  fatty  matters)  and  diet  (Pras'a)  abounding  in 
saltf  or  saline  articles  should  be  prescribed.  In  the  case 
of  the  aggravated  Vayu  being  incarcerated  in  the  Vasti 
(urinary  bladder),  diuretic  (lit.  bladder-cleansing) 
measures  and  remedial  agents  should  be  resorted  to. 
Anointing  with  medicated  oils,  Ghritas,  etc.,  application 
of  poultices  (Upanaha)  compounded  of  Vayu-subduing 
drugs,  massage,  and  plasters  (Alepa)  of  similar  pro- 
perties are  the  remedies  in  cases  where  the  aggravated 
Vayu  is  lodged  in  the  internal  ducts  or    channels  such 

*     One  Dharana  is  equal  to  four  Mashas. 
I     Sneha-Lavana  and  Kanda-Lavana,  etc. 

17 


290  THE   SUSHRUTA   SAMHITA.  [Chap.    iV. 

as  the  ears,  etc,  of  the  body.  Blood-letting  (vene- 
section) is  the  rem  edy  where  the  aggravated  Vayu 
would  be  found  to  be  confined  in  the  skin,  flesh, 
blood  or  veins  (Sirds).  Similarly,  application  of  fatty 
matters  (Sneha),  actual  cauterization,  massage,  appli- 
cation of  poultices  and  binding  of  ligatures  should  be  the 
remedies  where  the  aggravated  Vayu  would  be  found 
to  have  become  involved  in  the  Siia(yu  (ligaments),  joints 
and  boaes  Where  the  aggravated  Vayu  would  be 
found  to  have  become  situated  in  the  bone,  the  skin  and 
flesh  of  that  part  of  the  body  should  be  perforated  with 
a  proper  surgical  instrument  (Ara-Sastra)  and  the  under- 
lying bone  should  be  similarly  treated  with  an  awl.  A 
tube  open  at  both  ends  should  be  inserted  into  the 
aperture,  thus  made,  and  a  strong  physician  should  suck 
the  aggravated  Vayu  from  out  of  the  affected  bone  by 
applying  his  mouth  to  the  exteiior  open  end  of  the 
tube.     4-9. 

In  the  case  of  the  aggravatd  V^yu  having  contamin- 
ated the  semen,  measures  and  remedies  for  seminal  dis- 
orders (Sukra-doshai*  should  be  employed.  The  intelligent 
(physician)  would  take  recourse  to  measures,  such  as 
blood-letting,  immersion  or  bath  in  a  vessel  (full  of  Vayu- 
subduing  decoctions),  fomentation  with  heated  stones,  as 
well  as  in  the  manner  of  Karshu-Sveda,  vapour-bath  in 
a  closed  chamber  (Kuti  sveda),  anointment,  Vasti- 
Karmas,  etc.,  in  the  event  of  the  aggravated  Vayu  having 
extended  throughout  the  whole  organism ;  whereas 
bleeding  by  means  of  a  horn  (cuffing)  should  be 
regarded  as   the    remedy    when    the   aggravated    Dosha 

*  Treatmenls,  such  as,  the  purification  of  the  semen,  etc.,  and  the  use 
of  medicin  s  for  making  Aphrodisia  (Vaji-karana)  and  for  the  remedy 
of  the  disordered  urinary  organ  (Mutra-dosha)  should  be  adopted  and 
employed. 


Chap.  IV.]  CHIKITSA   STHANAM.  291 

would  be  found  to  have  been  confined  in    any    parti  ular 
part  of  the  body*     10-12. 

In  the  event  of  the  aggravated  Vayu  being  connected 
either  with  the  Pitta  or  the  Kapha,  such  a  course  of  treat- 
ment should  be  adopted  as  would  not  be  hostile  to  the 
two  other  Doshas.  Blood-letting  (in  small  quantities) 
should  be  resorted  to  several  times  in  a  case  of 
complete  senesthesia  (Supta-Vata)  and  the  body  should 
be  anointed  with  oil  mixed  with  salt  and  chamber-dust 
(Agcira-dhuma)  Milk  bailed  with  a  decoction  of  the 
drugs  of  the  Pancha-mula  group,  acid-fruits  (Phalamla), 
meat-soup  or  soup  of  (well-cooked)  corn  (Dhanya) 
with  clarified  butter  are  beneficial  in  cases  of  Vata- 
roga.     13-15. 

^alvana-Upanaha  :-A  poultice  composed 

of  the  drugs  of  the  Kdkolyadi  group,  the  Vayu-sub- 
duing  drugs  (those  of  Bhadra-ddrvddi  and  Vidari- 
gandhadi  groups),  and  all  kinds  of  acid  articlesf  (such  as, 
Kanjika,  Sauvira,  fermented  rice-gruel,  etc.),  the  flesh  of 
animals  which  live  in  swamps  (Anupa)  or  in  water 
(Audaka)l,  oil,  clarified  butter  and  all  kinds  of 
lardaceous  substances,  mixed  together  and  saturated 
with  a  profuse  quantity  of  salt  and  then  slightly  heated 
is  known  by  the  name  of  Salvana  A  person  suffering 
from  any  form  of  Vata  roga  should  be  always  treated 
with  such  Salvana  poultices  (Upanaha).  The  poultice 
should    be    applied  to    such  part     of    the    body   as   is 

*  It  is  to  be  understood  that  measures  and  remedies  laid  do^vn 
under  the  head  of  Sarvanga-gata  should  be  used  when  the  Vayu 
would  be  found  to  be  diffused  throughout  the  whole  organism  instead  of 
being  confined  to  any  specific  pari. 

t     According  to  others  it  means  all  kinds  of  acid- fruits,  etc. 

t  Chakradatla  reads  "^CT^^flt^l  ^rf^S:"  (well-cooked  with  the  flj.h 
of  "Anupa"  animals)  in  place  of  ^l'Tqt^8Rl^t€'^  I 


292  TJ'E  SUSHRUTA  SAMHITA.  [Chap.  IV. 

numbed,  painful  or  contracted  and  the  affected  part 
should  be  fiimly  bandaged  thereafter  with  a  piece  of 
Kshauma*  linen  (  r  woollen  cloth.  As  an  alternative, 
the  affected  part  should  be  plastered  (and  well  rubbed) 
with  the  ingredients  of  the  Salvana-Upanaha  and  inserted 
into  a  bag  made  of  cat  or  mungoose  skin  or  that  of  a 
camel  or  deer  hide.     i6. 

The  aggravated  Vayu,  if  located  in  the  shoulders,  the 
chest,  the  sacrum  i^Trika)  or  the  Manya,  should  be  subdued 
by  emetics  and  errhines  judiciously  employed.  Siro-Vasti 
should  be  applied  to  the  head  of  the  patient  as  long  as  it 
would  take  one  to  utter  a  thousand  Matras  (a  short  vowel 
sound),  more  or  less,  as  the  case  may  require,  where  the 
aggravated  Vayu  would  be  found  to  have  located  itsellf 
in  the  head,  (if  necessary)  blood-letting  should  be 
resorted  to.  As  a  mountain  is  capable  of  obstructing  the 
passage  of  the  wind,  so  the  Sneha-Vasti  (oily  enema)  is 
alone  capable  of  resisting  the  action  of  the  aggravated 
Vayu  whether  it  extends  throughout  the  whole  system 
or  is  confined  to  a  single  part.     17-19 

Measures  beneficial  to  Vata-Vyadhi: 

— An  app'.ication  of  Sneha,  fomentations,  anointment  of 
the  body,  Vasti,  oily  purgatives,  Siro-vasti,  the  rubbing  of 
oils  on  the  head,  oily  fumigation,  gargling  with  tepid  oil, 
oily  errhines,  the  use  of  meat-soup,  milk,  meat,  clarified 
butter,  oil  and  other  lardaceous  articles  (of  food),  all 
kinds  of  acid  fruits,  salt,  lukewarm  washes,  gentle 
massage,  the  use  of  saffron,  Agura^  Patra^  Kushtha,  Eld^ 
Tagara,  the  wearing  of  woollen,  silken,  cotton  or  any 
other  thick  kind  of  garments,  living  in  a  warm  room  or 
in  one  not  exposed  to  the  wind  or  in  an  inner  chamber, 
the  use  of  a  soft  bed,  basking  in  the  glare  of  fire,  entire 
sexual   abstinence,   these   and    such   like   other    things 

*     Some  lead  it  as  Valka,  i.e.^  made  up  bark. 


Chap.  IV  ]  CHIKITSA   STHANAM.  293 

should    be  generally  adopted  by  a  patient  suffering  from 
Vata-roga      20. 

The  Tilvaka-Ghrita  :— A  paste  (Kalka)  of 

the  following  drugs,  viz,  Trivrit,  Danti,  Suvarna-kshiri, 
Saptald,  S  amkhini^  Triphald  and  Vidariga,  each  weigh- 
ing an  Aksha  vtwo  tolas\  and  Tilvaka- roots  and 
Kmnpillaka^  each  weighing  a  Vilva  (eight  tolas),  a 
decoction  of  Triphala  and  curd,  each  weighing  two 
Patras  '■''  ^^thirty-two  seers)  and  clarified  butter,  weighing 
sixteen  seers,  should  be  duly  cooked  together.  Medical 
authorities  recommend  this  Tilvaka  Ghiila  as  an  oily 
purgative  in  cases  of  Vata-roga.  As'oka-Ghrita  and 
Ramyaka-Ghrita  aie  prepared  in  the  same  manner,  (viz., 
by  substituting  As'oka  and  Ramyaka  respectively  for 
Tilvaka).     21. 

The  Anu-Taila:— The  log  of  a  long-standing 
wooden  oil-mill  should  be  cut  into  small  chips  and  then 
thrashed  and  boiled  in  water  in  a  large  cauldron.  The 
globules  of  oil  that  will  be  found  floating  on  the  surface 
of  the  boiling  water  should  be  .'^kimmed  off  either  with 
the  hand  or  with  a  saucer.  The  oil  thus  collected 
should  then  be  cooked  with  the  Kalka  of  Vayu-subduing 
drugs  as  in  the  preparation  of  a  medicated  oil.  This 
oil  is  known  as  the  Anu-Taila-  The  use  of  this  oil  has 
been  advised  by  medical  authorities  in  cases  of  Vdta- 
roga.  This  oil  is  so  named  from  the  fact  of  its  being 
pressed  out  of  small  chips  of  oily  wood  (as  described 
above).     22. 

The    Sahasra-paka-Taila  :-The   wood 

of  drugs  belonging  to  the   group  of    Maha-pancha-mula 
should  be  collected  in  large  quantities  and    burnt    on    a 

*     Palra  means  64  Palas,  i  e.,    8    Seers,    but    in    cases   of  liquids   the 
weight  should  be  doubled, 


294  THE   SUSHRUTA   SAMIIITA.  [Chap  IV. 

plot   of  land,    so    as   to  make  the  soil    black.     The  fire 
should     be    kept    buniing    one   whole    night  ;    on    the 
following  morning  on  the  extinction  of  the  fire  the  ashes 
should  be  removed  and  the  ground,   when    cool,    should 
be  soaked  with  one  hundred  Ghatas    (six    thousand    and 
four   hundred    seers)    of    oil    cooked    with    the  drugs  of 
the  V id di'i-gandh a di  gj'oup  d^nd  with,  the   same   quantity 
of  milk    and    kept  in  that  condition  for  one  night  more. 
On  the  next  morning  the  earth  should  be  dug   up,  down 
to   the   stratum    found  to  have  been  soaked  with  the  oil 
and  the  soil  should  then  be  dissolved  in  warm  water    in 
large  cauldrons   for   the    purpose.     The  oil  that  will  be 
found  floating  on    the    surface    of  the  water   should    be 
skimmed  off  with  both  hands  and  kept  in  a  safe  basin. 
Then   the    decoction    of    the   Vayu-subduing  drugs  (the 
Bhadra-darvadi  group),  meat-juice,  milk,  fermented  rice- 
gruel   (each  taken  in    a    quantity    measuring   a   quarter 
part  of  that  oil)  should  be  taken    one   thousand    times 
and    each   time  should  be  boiled   with   the    oil.     Vayu- 
subduing  and  aromatic  drugs  and  spices,  in  the  northern 
(^trans-Himalaya)  and  southern  (Deccan)  countries,  should 
be  thrown    into  it  and  boiled  with  the  oil.     The    boiling 
should  be  completed  within  the  period  during   which   it 
could  be  properly  done.     Then  after    the    completion  of 
tne  cooking,  conch-shells    should  be   blown,    Dundubhis 
should    be   sounded,    umbrellas    should    be    held    open, 
ehowries     should     be    blown    into   it   and    a    thousand 
Brahmins  should  be  treated  with    repasts.     The    oil    so 
sacredly  prepared  should  be  stored  carefully    in   golden, 
silver  or  earthen    pitchers.     This     oil     is     called    the 
Sahasrapatka-Taila  and   is  of  irresistible  potency   and 
fit  even  for  the   use   of  kings.     Satapa(ka-Taila  is  also 
prepared  in  the  above  manner  (with  the  aforesaid    ingre- 
dients) by  cooking  it  one  hundred  times  only.     23. 


chap.  IV.]  CHIKITSA   STHANAM.  295 

The  Patra-Lavana  :— The  green  leaves  of  the 
Eranda  plants  and  those  of  the  trees  known  as  Mush- 
kaka,  Naktamdla,  Atarushaka,  Piiiika,  Aragvadha  and 
Chitraka  should  be  thrashed  with  (salt  of  equal  quantity) 
in  an  Udukhala  (a  hand  thrashing  mill)  and  placed  in 
an  earthen  pitcher,  saturated  with  oil  or  clarified  butter. 
Having  covered  the  mouth  of  the  pitcher  with  a  lid,  it 
should  be  plastered  and  burnt  in  fire  of  cow-dung. 
The  medicine  thus  prepared  t^with  the  help  of  internal 
heat)  is  called  the  Patra-Lavana.  Medical  experts 
advise  the  application  of  this  medicine  in  cases  of 
Vata-roga.     '^4. 

The  Kanda-Lavana  ".—Similarly,  Snuhi- 
twigs,  Brinjal  (Vdrtdku),  and  5' 4'"'''^- bark  (taken  in 
equal  parts)  and  rock-salt  (of  equal  weight  as  the  entire 
drugs)  should  be  thrashed  and  kept  in  a  pitcher.  Oil, 
clarified  butter,  lard  and  marrow  should  be  added  to 
it  equal  in  weight  with  salt  and  then  having  covered 
the  mouth  of  the  pitcher  with  a  lid,  it  should  be  plaster- 
ed and  burnt  in  a  fire  of  cow-dung  (as  before).  The 
use  of  this  medicated  salt  which  is  called  the  Kanda- 
Lavana  or  Sneha-Lavana  is  recommended  by  experts 
in  Vata-roga.     25. 

The  Kalyanaka-Lavana  :— The  follow- 
ing drugs  with  their  roots,  leaves  and  twigs,  viz,, 
Gandira^  Paldsa,  Kutaja,  Vilva,  Arka,  Snuhi,  Apd- 
indrga,  Pdtald,  P dribhadra^  Nddeyt,  Krishnagandhd 
Nipa,  Nimba,  Nirdahani,  Atarushaka,  Nakta-mdlaka, 
Putika,  Vfihati,  Kantikari,  Bhalldtaka,  Ingudi,  Baija- 
yanti,  Kadali,  Varshdbhu,  Hrivera^  Kshuraka,  Indra- 
vdruni,  S  vet  amoks  haka  and  Asoka  should  be  gathered  in 
a  green  condition  and  mixed  with  (as  large  a  quantity 
of)  rock-salt  and  having  thrashed  them  in  an  Udukhala 
should  be    burnt    in    a    hermetically   sealed    pitcher   as 


tg6  THE   SUSHRUTA  SAMIIITA.  [Chap.   iV. 

above,  after  which  it  should  be  filtered  (twenty  times) 
and  boiled  in  the  manner  of  alkaline  preparations  At 
the  close  of  the  boiling,  powders*  of  the  drugs  of  the 
Hingvddi  or  Pippalyadi  group  should  be  mixed  with 
it.  This  medicine  is  called  the  Kalsiynaka-Lavana  and 
is  specially  efficacious  in  all  cases  of  Vata-roga  and 
is  applicable  both  in  food  and  drink  in  cases  of  Gulma, 
enlarged  spleen,  impaired  digestion,  indigestion,  hae- 
morrhoids, intestinal  worms,  aversion  to  food  and 
cough.     26 . 

IVIemorable  Verse  :— The  remedy  proves 
efficacious  in  Vata-roga  through  its  heat-making  potency, 
power  of  liquifying  and  secreting  the  deranged  Doshas 
and  of  restoring  and  correcting  them  as  well.     27, 

Thus    ends   the    fourlh    Chapter   of    the    Chikitsila    Sthanam   in   the 
Sus'ruta  Samhita  which  deals  with  the  treatment  of  Vata-\  yadhi. 

*     The  total  weight   of  these    powders   should   be   one-fourth    of  the 
weight  of  the  rock-salt  taken  in  ihe  course  of  the  preparation.— Ddllana. 


I 


K 


CHAPTER  Y. 

Now  we  shall  discourse  on  the  chapter  which  deals 
with     the     medical    treatment     of     IVIaha-V^ta- 

Vyadhi.    i. 

Several  authorities  group  the  disease  Vata-Rakta 
under  two  different  sub-heads,  such  as  superficial  and 
deep-seated.  But  such  a  classification  is  arbitrary  and 
unscientific,  inasmuch  as  this  disease  first  manifests 
itself  on  the  surface  (layer  of  the  skin)  like  Kushtha  and 
gradually  invades  the  deeper  tissues  of  the  body.  Hence 
there  are  no  (two)  forms  of  this  disease.     i-2. 

Causes  of  V^ta-Rakta  :— The  Vayu   of 

the  body  is  enraged  or  agitated  by  such  causes  as 
wrestling  with  a  man  of  superior  and  uncommon  physical 
strength,  etc.,  while  the  blood  is  vitiated  by  such  causes 
as  constant  over-eating  of  edibles  which  are  of  difficult 
digestion  and  heat-making  in  their  potency  or  ingestion 
of  food  before  the  digestion  of  the  previous  meal.  The 
Vayu  thus  enraged  and  agitated  enters  into  the  blood- 
carrying  channels  of  the  body  and  being  obstructed 
in  its  passage,  becomes  mixed  with  the  vitiated  blood. 
The  deranged  Vayu  and  the  blood  thus  combine  to  give 
rise  to  a  disease  characterised  by  the  specific  symptoms 
of  each,  which  is  known  as  Vaita-Rakta.  The  charac- 
teristic pain,  which  at  first  confines  itself  to  the  extre- 
mities, gradually  extends  over  the  whole  body. 

Premonitory     symptoms    of    Vstta- 

Rakta  :  —The  disease  is  ushered  in  with  a  pricking 
pain,  a  burning  and  an  itching  sensation  (in  the  affected 
part),  a  swelling,  roughness  and  numbness  (anaesthesia) 
of  the  diseased  locality,  throbbing  of  the  veins,  ligaments, 

38 


^9^  tHE   SUSHRUTA  SAMHITA.  [Chap.  V. 

nerves  and  arteries,  a  weakness  in  the  thighs  and  sudden 
appearance  of  red  or  brownish  circular  patches  on  the 
palms  of  the  hands  and  soles  of  the  feet,  fingers  and  heels, 
etc.,  (A.  R. — wrists).  If  neglected  and  immoderately 
treated  in  its  premonitory  stages,  the  disease  soon 
develops  its  characteristic  symptoms  in  succession,  which 
have  been  described  before  ;  whereas  (a  lifelong)  defor- 
mity (of  the  affected  part)  is  the  penalty  for  neglecting 
it  (in  its  fully  patent  or  developed  stage).     3. 

Memorable  Verse  : — Men  of  a  mild  and  deli- 
cate constitution,  as  well  as  those  who  are  (inordinately) 
stout  or  sedentary  in  their  habits  or  are  addicted  to 
unwholesome  and  incompatible  food,  etc.,  are  generally 
found  to  be  susceptible  to  an  attack  of  Vaita-Rakta.     4. 

PrOgTIOSiS  : — A  physician  is  advised  to  take  in 
hand  the  medical  treatment  of  a  Vata-Rakta-patient 
who  has  as  yet  not  lost  much  strength  and  muscle,  nor  is 
afflicted  with  thirst,  fever,  epileptic  fits,  dyspnoea,  cough, 
numbness  (of  the  affected  part),  aversion  to  food,  indi- 
gestion, extension  and  contraction  of  the  limb,  as  well 
as  of  a  person  who  is  strong  and  temperate  in  his  living 
and  can  afford  to  pay  for  the  diet  and  other  necessary 
accessories  of  the  treatement.     5. 

Preliminary  remedial  measures  :— in 

the  first  stage  of  the  disease  the  blood,  having  become 
vitiated  owing  to  its  being  obstructed  in  its  course  (by 
the  unusually  agitated  Vayu  in  the  system),  should  be 
gradually  and  not  profusely  bled,  except  when  the  body 
would  be  found  to  have  become  extremely  dry  or  to  have 
lost  its  natural  healthful  glow  or  complexion  through  the 
action  of  the  aggravated  morbific  principle  (Vdyu),  for 
fear  of  further  aggravating  the  Vayu.  Emetics,  purga- 
tives, and  Vasti  (enemas),  etc.,  should  be  administered 
and  the  patient  should  be  made  to  take  a  diet  consisting 


Chap,  v.]  CHIKITSA  STHANAM.  299 

of  old  and  matured  clarified  butter  (and  boiled  rice),  in 
the  case  where  the  aggravated  condition  of  the  deranged 
Vayu  would  be  found  to  predominate.  As  an  alternative, 
he  should  be  made  to  drink  a  potion  consisting  of  goat's 
milk  mixed  with  half  its  quantity  of  oil,  with  two  Tola 
weight  of  Yashti-madhu  or  goat's  milk  cooked  with 
Pris'niparni  (two  Tola  weight)  with  honey  and  sugar 
(added  after  cooking),  or  cooked  with  S'unthi,  S'ringd- 
taka,  and  Kas'eruka,  or  cooked  with  Syamd,  Rdsnd, 
Sushavi,  Pris'niparni^  Pilu,  S'atdvari,  S'vadojnshtrd  and 
Das'a-fmda.     6 

Oil,  cooked  with  the  addition  ol  milk  previously 
boiled  with  the  decoction  of  Das'a-mula  of  eight  times 
its  own  weight  and  a  Kalka  of  Madhuka,  Mesha-s'ringi 
(A.  R.  Sarngashta),  S'vadmnshtrd,  Sarala,  Bhadra-ddru^ 
Vachd  and  Surabhi  pasted  together,  should  be  adminis- 
tered in  drinks,  etc  ,  (viz  ,  anointment,  sprinkling,  etc.\ 
As  an  alternative,  the  oil  cooked  with  the  decoction  of 
S'atdvari,  Mayuraka,  Madhuka,  Kshira-Viddri^  Vald, 
Ati-vald  and  Trina-pancha-mula .  with  the  paste  of  the 
drugs  belonging  to  the  Kdkolyddi  group,  or  the  oil^^ 
cooked  with  the  decoction  and  a  Kalka  of  Vala  for 
a  hundred  times  should  be  prescribed  for  the  patient. 
The  affected  part  should  be  washed  with  the  milk,  boiled 
with  the  roots  of  the  Vata-hara  (Vayu-subduing)  drugs 
(?>.,  Das'a-mula),  or  simply  with  Amla  (gruel,  etc.),  or 
a  plaster  composed  of  barley,  Madhuka,  Eranda  (castor) 
and  Varshdbhu  (pasted  together  and  heated),  should  be 
applied  to  the  part.     7. 

Plasters,     etc.  : — Barley,    wheat,      sesamum, 
Mudga  pulse  aud  Masha  pulse  should  be  taken  in    equal 

*  According  to  Jejjata  Acharyya,  the  *' Vala-Taila",  which  is 
administered  in  the  medical  treatment  of  Mudha-garbha,  should  be 
prescribed  in  this  case. 


300  THE  SUSHRUTA  SAMHITA.  [Chap.  V. 

parts  and  pounded  separately  ;  and  the  paste  of  the 
following  drugs,  viz.,  Kdkoli,  Kshira-kdkoli,  /ivaka, 
RishabhakUy  Vald,  Ati-vald^  Visa-mrindla  (lotus  stem), 
Pris'niparni,  Mesha-s'ringi,  Piydla^  S'arkard  (sugar), 
Kas'eruka,  Surabhi,  and  Vachd  should  be  mixed  with 
each  of  the  preceding  powders  and  each  of  these 
compounds  (so  formed)  should  be  boiled  with  milk, 
oil,  lard,  marrow  and  clarified  butter.  The  five 
compounds,  thus  prepared,  are  called  Pa^yasas,  which 
should  be  applied  as  a  hot  poultice  (Upandha)  to 
the  affected  part  ;  or  an  Utkarikgk,  made  of  the  pulp 
of  oily  fruit  (seeds)  *  (prepared  by  cooking  them  with 
milk)  should  be  applied  ;  or  powders  of  wheat,  barley, 
sesamum,  Mudga  pulse,  or  Masha  pulse,  and  Vesavdra, 
made  of  various  kinds  of  fish  and  flesh,  should  be  used 
as  a  plaster.  Vilvapes'ikd,  Tagara,  Deva-ddru,  Sarald^ 
Rdsnd,  Harenu,  Kushtha,  S'ata-pushpd,  Eld,  Surd  and 
cream  of  milk-curd  pasted  together,  should  be  applied 
to  the  affected  part  as  a  plaster  (UpanaLha'.  As  an 
alternative,  the  expressed  juice  of  Matulunga,  mixed  with 
Kanjika,  Saindhava  salt  and  clarified  butter,  pasted  to- 
gether with  the  root  of  the  Madhu-s'igru  and  with  sesa- 
mum,-]- should  be  used  in  a  similar  way.  The  preceding 
remedies  should  be  administered  in  a  case  of  Vaita-Rakta 
maiked  by  a  preponderance  of  the  aggravated  Vayu.     8. 

Vata-Rakta  with    a  preponderance 

of  Pitta  : — In  cases  of  Vdta-Rakta  where  the  Pitta 
preponderates,  the  patient  should  be  made  to  drink  a 
potion  consisting  of  a  decoction  of  Drdkshd,  Aragvadha^ 
Katphala,  Kshira-viddri,  Yashti-madhu,  Chandana  and 
Kds  w^r^'<3!  sweetened  with  a  quantity  of  sugar  and  honey. 

*    Such  as  sesamum,  castor-seed,  linseed,  Vibhitaka-seeds,  etc. 
t    Some  say  that  a   paste  of  sesamum  only  should  be  used   as  a 
i  separate  plaster. 


Chap,  v.]  CHIKITSA  STHANAM.  3OI 

As  an  alternative,  a  decoction  of  S'atdvari,  Yashti- 
madhu,  Patola,  Triphald,  and  Katu-rohini^  or  a  decoction 
of  Guduchi^  or  a  decoction  of  the  drugs  belonging  to  the 
Chandanadi  group,  which  are  possessed  of  virtues  for 
allaying  pittaja  fever,  should  be  administered  to  the 
patient,  sweetened  with  sugar  and  honey.  Clarified 
butter,  cooked  and  prepared  with  a  decoction  of  bitter 
and  astringent  drugs*  also  proves  beneficial  in  such 
cases.     9. 

The  affected  part  should  be  washed  (Parisheka)  with 
a  decoction  of  Visa-mrindla,  Chandana  and  Pad?naka 
(taken  in  equal  parts  and)  mixed  with  half  its  quantity 
of  milk.  As  an  alternative,  the  affected  part  should  be 
sprinkled  with  a  compound  composed  of  milk,  the 
expressed  juice  of  Ikshu  (sugar-cane),  honey,  sugar,  and 
washings  of  rice  (taken  in  equal  parts)  ;  or  with  curd- 
cream,  honey,  and  Dhanydmla  (fermented  paddy-gruel), 
mixed  with  a  decoction  of  grapes  and  Ikshu  ;  or  the 
affected  part  should  be  anointed  with  clarified  butter 
cooked  with  the  drugs  of  the  Jivaniya  group,  or  with  the 
clarified  butter  washed  a  hundred  times  in  water,  or 
with  clarified  butter  cooked  with  the  Kalka  of  the 
Kdkolyddi  group.     10. 

Pradeha  (plaster)  composed  of  S'dli,  Shashtika,  Nala^ 
Vanjula,  Tdlis'a,  S'rigdtaka^  Galodya,  Haridrd,  Gairika^ 
S'aivala,  Padma-kashtha,  leaves  of  padma  (lotus),  pasted 
with  Dhdnydmla  and  mixed  with  clarified  butter,  should 
be  applied  to  the  affected  part.  This  plaster  (Pradeha) 
may  be  applied  lukewarm  even  in  cases  of  Vdta-Rakta, 
marked  by  a  preponderance  of  the  aggravated  Vayu. 
All   the    remedial  measures  (laid  down  above)  may  also 

*     D.  R.— Sweet,  bitter,  and  astringent  drugs. 

Bitter   drugs— Patoladi  group  ;    Kashdya   drugs— Triphaladi   group  ; 
sweet  drugs— Kakolyadi  group. 


302  THE   SUSHRUTA   SAMHITA.  [Chap.  V. 

be  advantageously  applied  in  cases  marked  by  a  pre- 
ponderance of  the  vitiated  blood,  with  this  exception 
that  cold  plasters  and  repeated  blood-lettings  should 
be  resorted  to  in  the-  latter  (Raktaja-Vata-Rakta).     ii. 

Vata-Rakta  with   a   preponderance 

of  Kapha:— Incases  where  the  Kapha  preponderates, 
the  patient  should  be  made  to  drink  a  potion  consisting 
of  a  decoction  of  Haridrd  and  Amalaka,  sweetened  with 
honey  ;  or  a  decoction  of  Triphald,  or  a  Kalka  of 
Madhuka,  S'ringavera,  Haritaki  -ax^A  Tikta-rohini  m.x'K.Q.d 
with  honey.  As  an  alternative,  Haritaki  and  treacle 
with  either  cow's  urine  or  water,  should  be  given  to  him. 
The  affected  part  or  limb  should  be  sprinkled  or 
washed  with  cow's  urine,  oil,  alkaline  water,  Sura,  Sukta, 
or  with  a  decoction  of  Kapha-destroying  drugs.  A  hot 
decoction  of  the  drugs  constituting  the  Aragvadhadi 
group  may  be  used  with  benefit  in  sprinkling  the 
affected  part.  The  body  of  the  patient  should  be  lubri- 
cated or  anointed  with  clarified  butter,  boiled  with 
the  cream  of  milk-curd,  cow's  urine,  wine,  S'ukta'd.nA 
with  the  Kalka  of  Yashti-madhu,  Sdrivd  and  Padma- 
kdshtha.  A  plaster  (Pradeha),  composed  of  pounded 
sesamum,  mustard  seed,  linseed  and  barley  (taken  jn 
equal  parts)  and  mixed  and  pasted  with  S'leshmdtaka, 
Kapittka,Madhu-s'{grudLXid.covj's  urine,  and  Yava-kshdra 
should  be  applied  (hot  to  the  seat  of  the  disease).     12-13. 

The  Five  Pradehas  :--(i)Apaste  of  white 

mustard  seed,   (2,  that    of    sesamum    and  As'vagandha, 

(3)  a  similar  paste  of  Piydla,  S'elu  and   Kapittha  bark, 

(4)  that  of  Madhu-ii'gxw,  Punarnavd  and  (5^  a  paste  of 
Vyosha,  Tiktd,  Prithakparni  and  VriJiati,  these  five 
kinds  of  Pradehas  should  be  separately  pasted  with 
alkaline  water  and  (any  of  them)  applied  lukewarm  to 
the  affected  locality.     14. 


Chap,  v.]  CIIIKITSA   STHANAM.  303 

As  an  alternative,  a  plaster  composed  S'dlaparni, 
Pris'niparni,  Vrihati  and  Kantakdri,  pasted  together 
with  milk  and  mixed  with  Tarpana  *  should  be  applied 
(to  the  seat  of  the  disease).  In  cases  of  Vata-Rakta 
involving  the  concerted  action  of  two  or  three  of  the 
Doshas,  the  remedy  consists  in  applying  such  drugs  in 
combination  as  are  possessed  of  the  efficacy  of  subduing 
the    action    of    each  of  them.     15. 

Guda-Haritaki  and  Pippali-Vardha- 

mana  Yogas  : — Haritaki  with  treacle  may  be  used 
in  all  types  of  Vata-Rakta.  As  an  alternative,  the 
patient  should  be  enjoined  to  use  Pippali,  pasted  with 
miik  or  water,  every  day  (in  the  following  way).+  The 
number  of  Pippali  should  be  increased  by  five  or  ten 
respectively  on  each  successive  day  till  the  tenth  day  of 
its  use  ;  after  which  period  the  number  of  Pippali  should 
be  decreased  (by  a  similar  number)  on  each  successive 
day  till  it  is  reduced  to  the  original  five  or  ten.  The 
patient  should  live  on  a  diet  of  milk  and  rice  only  (during 
the  entire  course  of  this  treatement).  This  medicine 
which  is  known  as  the  Pippali-Vardhamana,:|:  proves 
efficacious  in  cases  of  Vata-Rakta,  chronic  fever 
(Vishama-Jvara),  aversion  to  food,  jaundice,  enlarged 
spleen,  piles,  cough,  asthma,  cedema,  phthysis,  loss  of 
appetite,  heart-disease  and  ascitis.     16. 

Clarified  butter,  cooked  in    milk    with  the    paste   of 
the    drugs   of    the    Jivaniya   group,   should    be  used  in 

*  Flour  of  barley  or    fried   grain,    dissolved    in    water,    is   known   as 
Tarpana. 

tThe  dosage  should  begin  originally  with  five  or  ten  Pippalis  according 
to  the  strength  of  the  patient. 

X  Maharshi  Charaka  mentions  this  Yoga  in  the  chapter  on  Rasayana 
and    prescribes  it  also  in  the  treatement  of  Udara.    Chakradatta  mentions 
the  use  of  this  medicine   in    the   treatment    of  liver   and    spleen   and   of 
fever. 


304  THE  SUSHRUTA   SAMHITA.  [Chap.    V. 

anointing  (the  body  of  the  patient).  A  plaster,  composed 
of  Sahd,  Sahadevd,  Chandana,  Murvd,  Mustd,  Piydla, 
S'atdvari^  Kas'eru ,  Padma-kdstha  Yashti-madhu,  S'ata- 
pushpd  (A.  D.  Vidari)  and  Kushtha,  pasted  together  with 
milk  and  mixed  with  the  cream  of  clarified  butter,  should 
be  applied  (hot)  to  the  affected  locality.  A  plaster 
composed  of  Saireyaka,  Atarushaka,  Vald,  Ati-vald 
Jivanti  and  Sushazi^  pasted  together  with  the  milk  of  a 
she-goat,  should  be  likewise  applied  (to  the  seat  of  the 
disease).  As  an  alternative,  the  diseased  locality  should 
be  plastered  with  the  pastes  of  Kds'marya^  Yashti- 
madhu  and  Tarpana  mixed  together ;  or  it  should  be 
treated  with  Pinda-Taila,  prepared  by  cooking  Madhu- 
chchhishta  (bee's  wax),  Manjishthd,  resin,  and  Ananta- 
mula  in  milk*  (and  oil  taken  together).     17-20. 

In  all  cases  of  Vata-Rakta,  old  and  matured  clarified 
butter  boiled  with  the  expressed  juice  of  Amalaka 
should  be  prescribed  as  drinks.  The  affected  part 
should  be  washed  or  sprinkled  with  old  and  matured 
clarified  butter,  boiled  with  a  decoction  and  paste 
(Kalka)  of  the  drugs  belonging  to  the  Kdkolyddi  group, 
or  with  those  of  the  Jivaniya  group,  or  with  the  decoc- 
tion of  Sushavi,  or  of  Karavellaka.  The  Vala-Tailat 
should  be  used  for  sprinkling  and  immersing  purposes, 
and  as  drink  and  Vasti-karma  (enemas). 

Diet: — The  diet  should  consist  of  articles  made 
of  old  and  matured  S'ali  or  Shashtika  rice,  wheat  or 
barley,   taken    with   milk  |  or   with  the  soup  of  Mudga 

*  Milk  four  times  of  oil  should  be  taken. 

I  The  "Vald-Taila"  described  in  the  medical  treatment  of  Mudha- 
garbha,  ch.  XV. 

X  In  the  case  of  Vata-roga  with  preponderant  Pitta,  the  patient  should 
take  the  food  with  milk  ;  in  the  preponderance  of  Vayu,  with  the  soup  of 
Jangala  meat;  and  in  the  preponderance  of  Kapha,  with  Mudga-soup, 
devoid  of  any  acid  combination. 


Chap,  v.]  CHIKITSA  STHANAM.  305 

pulse  or  flesh  of  Jdngala  animals  and  devoid  of  any 
acid  combination.*     21. 

Frequent  blood-letting  should  be  resorted  to  and 
measures,  such  as,  emetics,  purgatives,  Asthapana  and 
Anuvasana  should  be  adopted  in  cases  of  the  aggravated 
Doshas-|*  (involved  in  the  case).     22. 

Memorable    Verses :— A   case    of    Vdta- 

Rakta  of  recent  growth,  proves  readily  amenable  to  the 
remedial  measures  described  before.  Long-standing,  i.e., 
chronic  cases  (of  Vdta-Rakta)  are  never  perfectly  cured, 
but  can  only  be  palliated.  The  application  of  poul- 
tices (Upandha),  of  medicinal  washes  or  sprinkles  (Pari- 
sheka),  hot-plasters,  anointings  (Abhyanga),  spacious 
and  comfortable  bed-chambers  which  do  not  admit  of 
too  large  an  influx  of  air,  shampooing,  and  the  use 
of  soft  and  pleasant  beds  and  soft  pillows,  are  chiefly 
recommended  in  a  case  of  Vata-Rakta ;  whereas  physical 
exercise,  sexual  intercourse,  display  of  anger,  the  use  of 
heat-making,  saline,  acid  and  difficultly  digestible  food 
and  eatables  producing  eff^use  serus  or  slimy  matter  in 
the  bodily  channels,  and  sleep  in  the  day-time  (should 
be  deemed  extremely  injurious  and  hence)  should  be 
studiously  refrained  from.     23. 

The    Medical    Treatment  of  Apata- 

naka  : — The  medical  treatment  of  a  patient  suffering 
from  Apatainaka  (hysterical  convulsions),  not  exhibiting 
fixedness  of  gaze  and  arched  eye-brows,  with  an  absence 

*  In  the  case  of  Vata-roga,  with  a  preponderance  of  Pitta,  the  patient 
should  take  his  food  with  milk  ;  in  the  preponderance  of  Vayu,  with  the 
soup  of  Jangala  meat ;  and  in  the  preponderance  of  Kapha,  with  Mudga- 
soup,  devoid  of  any  acid  combination. 

t  In  the  preponderance  of  Kapha,  emetics  should  be  employed  ;  in 
the  preponderance  of  Pitta,  purgatives  should  be  given  ;  and  in  the  pre- 
ponderance of  Vayu,  Anuvasana  and  Asthapana  measures  should  be 
resorted  to. 

39 


306  THE   SUSilRtJTA  SAMHltA.  [Chap.    V. 

of  perspiration,  quivering,  delirium  and  the  numbness 
of  genitals,  found  not  to  fall  on  the  ground  but  capable 
of  being  supported  on  his  arms  (Akhattd-pati)  and  whose 
trunk  is  not  bent  or  arched  on  its  posterior  (dorsal)  side 
(Vahirayama),  may  be  attempted  (with  success).  The  body 
of  the  patient  should  be  first  anointed  with  emulsions 
(Sneha)  and  then  fomented  ;  strong  medicated  snuff 
should  then  be  administred  for  purifying  (the  accumu- 
lated mucus  in)  the  head.  After  that  the  patient  should 
be  made  to  drink  a  clear  potion  prepared  of  clarified 
butter,  cooked  in  combination  with  a  decoction  of  the 
drugs  constituting  the  Viddri-gandhadi  group,  extract 
of  meat,  milk  and  milk-curd,  so  as  to  arrest  the  further 
expansion  of  the  deranged  Vayu  into  the  system. 

Traivrita  Ghrita  :— A  decoction  of  the  Vayu- 
subduing  drugs,  such  as,  Bhadra-ddrvddi,  etc.,  barley, 
Kulattha  pulse,  Kola,  and  the  flesh  of  the  Anupa  and 
Audaka   animals   with    the    Pancha-Vargas*    should  be 

*  According  to  Jejjata,  "Pancha-Vargam"  means  the  flesh  of  the  five 
kinds  of  Anupa  animals,  z//s.,  Kulachara,  Plava,  Kos'astha,  Padin  and 
Matsya  (fishes). 

The  reading  here  is  doubtful.  The  term  "Audaka"  in  the  compound 
word  **  Sanupaudaka-mamsam  "  seems  to  be  redundant,  inasmuch  as 
•'Audaka"  animals  are  included  in  the  "Anupa"  class.  (Sutra,  chap. 
XLVI.  Page  487,  Vol  I).  In  this  case  the  word  "  Pancha-vargam  "  also 
seems  to  be  only  an  explanation  of  the  term  "Anupa"  meaning  the  fiive 
kinds  of  Anupa  flesh,  and  it  seems  to  have  surreptitiously  crept  into  the  body 
of  the  text  from  the  marginal  notes  of  some  authoritative  manuscript  copy 
of  the  book.  If,  however,  we  are  to  abide  by  the  current  reading  of  the 
book,  "Pancha-varga"  cannot  mean  the  five  kinds  of  flesh  in  the  presence 
of  the  word  ''Audaka"  mentioned  separately,  as  Jejjata  would  have  it.  In 
that  case  it  can  only  mean  either  the  five  groups  of  Pancha-mulas,  viz.,  the 
major  Pancha-mulas,  the  minor  Pancha-mulas,  the  Valli-Pancha-mulas, 
the  Kantaka-Pancha-mulas  and  the  Tiina-Pancha-mulas.  (Sutra,  chap. 
XXXVIII,  Pages  355-6,  Vol.  I),  as  some  would  explain  it  to  mean.  Others, 
however,  prefer  the  reading  as  it  \i  and  explain  the  term  "Fancha-varga" 
to  be  the  five  kinds  of  medicinal  drugs  mentioned  before  in   the   sentence, 


I 


Chap,  v.]  CriIKITSA   STHANAM.  307 

made.  The  decoction,  thus  prepared,  should  be  mixed 
with  milk  and  fermented  rice-gruel,  etc.,  and  then  cooked 
with  an  adequate  quantity  of  clarified  butter,  oil,  lard 
and  marrow  by  casting  Kalka  (paste)  of  the  Madhura 
(Kakolyadi  group)  into  it  This  Traivrita  Ghrita*  (lit. 
consisting  of  clarified  butter  with  three  other  lardaceous 
articles),  thus  prepared,  should  be  administered  to 
Apatanaka-patients  in  potions  and  diet,  in  effusions 
and  immersions,  in  anointings  and  errhines,  as  well  as 
in  Anuvasana  measures.  Diaphoretic  measures  should 
be  applied  according  to  the  prescribed  rules.  In  a 
case  marked  by  an  unusually  aggravated  condition  of 
the  YAyu,  the  patient  should  be  made  to  stand  neck-deep 
in  a  pit  tolerably  warmed  or  heated  with  burning  husks, 
and-  cow-dung.  As  an  alternative,  Palas'a  leaves  should 
be  strewn  over  a  hot  stone-slab  or  over  a  hot  oven, 
after  having  sprinkled  wine  over  them,  and  the 
patient  should  be  laid  full  length  upon  these  leaves,  or 
fomentations  should  be  made  with  Ves'avdra,  Kris'ara 
and  Pdyasa.     24—25. 

An  oil,  cooked  in    combination    with   the    expressed 

viz.,  the  Vataghna  drugs,  Yava,  Kola,  Kulaltha  and  flesh.  Oihers,  again, 
mean  by  the  term  "Pancha-varga"  the  five  parts,  viz.,  leaf,  fruit,  flower, 
bark  and  root,  of  the  Vataghna  drugs  mentioned  in  the  sentence. 

We  have,  however,  the  authority  of  Vagbhata  and  Chakradatta  in  our 
side  to  accept  the  first  view  that  the  term  "Audaka"  is  redundant,  in- 
asmuch as  they  have  not  read  the  word  "Audaka"  in  their  compilations. 
—Ed. 

*  According  to  Dallana,  four  seers  of  clarified  butter,  oil,  lard  and 
marrow  (each  weighing  one  seer),  sixteen  seers  of  Kanji,  etc.,  sixtetn  seers 
of  milk,  sixteen  seers  of  the  decoction  and  one  seer  of  the  Kalka  (paste) 
should  be  taken  in  its  preparation.  But  Gayadasa  is  of  opinion  that 
four  seers  of  milk  should  be  taken  instead  of  sixteen  seers. 

Four  seers  of  Ghrita,  etc.,  four  seers  of  milk,  six  seers  of  Kanji,  six 
seers  of  the  decoction  and  one  seer  of  the  Kalka  (paste)  are  generally 
taken   byexperienced  physicians  in  its  preparation.— Ed. 


308  THE  SUSHRUTA  SAMHITA.  [Chap.    V. 

juice  oi  Mulaka,  Eranda,  Sphurja,  Arjaka,  Arka^  Saptald 
and  S'amkhini  should  be  used  in  washing  (Parisheka), 
etc.,  the  body  of  an  Apatdnaka-patient.  Potions  con- 
sisting of  sour  Dadhi  (milk-curd)  mixed  with  powdered 
pepper  and  Vachd,  or  of  oil,  clarified  butter,  lard, 
or  honey,  mixed  with  the  same  things  and  taken 
in  an  empty  stomach,  prove  curative  in  cases  of 
Apatanaka.     26. 

These  remedial  measures  are  applicable  in  cases  of 
Apatanaka  when  the  action  of  the  aggravated  Vayu 
alone  preponderates.  In  a  case  involving  the  concerted 
action  of  two  or  mere  of  the  Doshas,  drugs,  remedial 
to  each  of  them,  should  be  combinedly  employed. 
Medicinal  liquid  errhines  {Avapida)  should  be  employed 
after  the  subsidence  of  a  severe  attack.  The  fat  or  lard 
of  a  cock,  crab,  Krishna-fish,  porpoise  or  of  a  boar 
should  be  taken*  by  the  patient.  As  an  alternative, 
he  should  be  made  to  drink  (a  potion  consisting  of) 
milk  boiled  with  Vdyu-subduing  drugs  (Das'a-mula,  etc.), 
or  a  gruel  (Yavdgu)  composed  of  barley,  Kola,  Kulattha- 
pulse  and  Mulaka,  cooked  with  curd,  oil  and  clarified 
butter.  Oily  purgatives,  Asthapana  and  Anuvasana 
measures,  should  be  employed  if  the  paroxysm  does 
not  subside  even  in  ten  days.  Medicines  and  remedial 
measures  laid  down  under  the  head  of  Vata-vyddhi 
and  the  process  of  Raksha-karma,  should  be  likewise 
adopted  (in  cases  of  Apatanaka).     27. 

Treatment  of  Pakshaghata  :— A  physi- 
cian is  enjoined  to  take  in  hand  the  medical  treatment 
of  a  patient  laid  up  with  Pakshaghata,  unattended 
by  a  discolouring  of  the  skin,  but  having  pain  in  the 
affected   part,   and   who  habitually  observes  the  rules  of 

*     Vriddha  Vagbhata    recommends   external   application    with    these 
lards. 


Chap,  v.]  CHIKITSA  STHANAM.  309 

diet  and  regimen  and  who  can  afford  to  pay  for  the 
necessary  accessories.  The  affected  part  should  be  first 
anointed  and  then  fomented.  Mild  emetics  and 
purgatives  should  be  subsequently  employed  for  the 
purpose  of  cleansing  the  system.  Medicated  Anuvdsana 
and  Asthdpana  measures  should  then  be  employed,  after 
which  the  general  directions  and  remedial  measures, 
laid  down  under  the  treatment  of  Akshepaka^  should 
be  followed  and  employed  at  the  proper  time  Appli- 
cations of  the  Mastikya-Siro-vasti  with  the  Anu-taila  for 
anointing  the  body,  of  the  articles  of  Salvana-Sveda 
for  the  purpose  of  poulticing,  and  of  the  Vahi-taila  as  an 
Anuvdsana  measure,  are  the  marked  features  of  the 
medical  treatment  of  this  disease,  and  should  be  followed 
carefully  for  a  continuous  period  of  three  or  four 
months.     2g. 

These  preceding  remedies  as  well  as  dry  fomenta- 
tions (Ruksha-sveda)  and  errhines,  which  possess 
the  virtue  of  subduing  the  deranged  Vdyu  and 
Kapha  should  be  likewise  employed  in  cases  of  Manya- 
stambha.    29 

Treatment  of    Apatantraka  : —Fasting 

is  prohibited  in  cases  of  patients  suffering  from  Apa- 
tantraka (Apoplectic  convulsions).  Emetic,  Asthapana 
and  Anuvdsana  measures  are  likewise  forbidden.  The 
passage  of  respiration  should  be  blown  open  by  violent 
breathings  in  the  event  of  its  being  choked  up  with  an 
accumulation  of  the  deranged  Vayu  and  Kapha.  The 
patient  should  be  made  to  drink  a  potion  consisting  of 
Tumburu,  Pushkara,  Hingu,  Amla-vetasa^  Haritaki  and 
the  three  (ofilicinal)  kinds  of  salts,  with  a  decoction 
of    barley.*     As   an    alternative,   four  seers  of  clarified 

*  Chakradatta  quotes  this  in  the  chapter   on    the    treatment   of   colic 
(s'ula),  but  does  not  read  *Amla-vetasa'  there. 


310  THE   SUSHRUTA   SAMHITA.  [Chap.  V. 

butter,  cooked  in  combination  with  sixteen  seers  of 
milk,  two  Pala  weight  of  Sauvarchala  salt  and  fifty  of 
Haritakis  should  be  prescribed  for  the  use  of  the  patient. 
All  other  remedial  agents,  possessing  the  virtue  of 
subduing  the  deranged  Vayu  and  Kapha  should  be 
likewise  employed.     30. 

Treatment  of  Ardita  :— A  patient  suffering 

from  Ardita  f/acial  Paralysis)  should  be  treated  with  the 
measures  and  remedies  laid  down  under  the  head  of 
Vata-vyadhi  in  the  event  of  his  being  found  to  be  suffi- 
ciently strong  and  capable  of  affording  the  neces- 
sary expenses  for  his  treatment.  Errhines,  Mastlkya- 
Siro-vasti,  inhalation  of  the  smoke  (Dhuma-pdna)  from 
medicated  drugs,  poulticing  (Upandha),  unguents  and 
Nddi-sveda,  etc.,  are  the  special  features  of  the  medical 
treatment  of  this  disease.  After  that,  a  decoction  should 
be  made  of  the  drugs  constituting  the  groups  of  Trina- 
Pancha-mula,  Mahd-Pancha-mula,  Kdkolyddid^nd  Viddri- 
gandhddi  groups,  aquatic  bulbs,  and  the  flesh  of  animals 
which  are  aquatic  in  their  habits  (Audaka)  and  those 
which  frequent  swampy  places  (Anupa),  by  boiling  them 
together  with  a  Drona  measure  of  milk  and  double  the 
quantity  of  water.  The  decoction  should  be  considered 
boiled  when  three  quarter  parts  of  its  original  weight  of 
the  liquid  has  been  evaporated  and  should  then  be 
strained.  The  decoction  thus  prepared  should  be  boiled 
with  a  Prastha  measure  of  oil  (four  seers)  and  be  removed 
from  the  fire  when  the  oil  is  well  mixed  with  the  milk. 
The  compound  (oil  and  milk)  thus  prepared  should  be 
allowed  to  cool  down  and  then  churned.  The  churned 
off  cream  (Sneha)  should  be  again  boiled  wuth  the  drugs 
of  the  Madhura  (Kdkolyddi)  group,  Mdsha-parni  and 
milk  (four  times  that  of  the  original  oil).  This 
medicated  oil  is  known  as  the  Kshira-Taila  and  should 


Chap,  v.]  CHIKITSA  STHANAM.  3II 

be  administered  as  potions  and  unguents,  etc,  to  an 
Ardita-patient  The  above  preparation  with  clarified 
butter  in  the  place  of  oil  is  known  as  the  Kshira- 
sarpih  and  it  should  be  used  as  an  Akshi-tarpana  (eye- 
lotion).     31—32. 

Venesection  should  be  duly  resorted  to  in  the  affect 
ed  parts,  according  to  the  directions  given  before,  in  cases 
of  Sciatica,  Gridhrasi,  Vis'vachi  (Synovitis  of  the  knee- 
joints),  Kroshtuka-sirah,  Khanja  (lameness),  Pangula, 
Vata-kantaka,  Pdda-ddha,  Pada-harsha,  Ava-vahuka  and 
Vadhiryya  and  in  cases  where  the  deranged  Vayu  would 
be  found  to  be  seated  in  a  Dhamani.  Measures 
and  remedies  laid  down  under  the  head  of  Vata- 
vyadhi  should  be  adopted,  except  in  a  case  of 
Ava-vahuka      33. 

The  expressed  juice  of  green  ginger,  made  lukewarm 
after  mixing  it  with  (equal  quantities  of)  oil,  honey  and 
Saindhava  salt,  should  be  poured  into  the  cavity  of  the 
ear  in  a  case  of  (acute)  ear-ache.  As  an  alternative, 
the  urine  of  a  she-goat,  or  oil  and  honey,  or  oil  with 
the  urine  (of  a  cow)  mixed  with  the  expressed  juice  of 
Mdtulunga,  pomegranate  and  tamarind,  or  the  oil  boiled 
and  prepared  with  Surd,  Takra,  Sukta,  salt  and 
the  urine  (of  a  cow),  should  be  poured  into  the  cavity  of 
the  ear  ;  fomentation  should  be  given  (to  the  interior  of 
the  affected  organ)  after  the  manner  of  Nddi-sveda. 
The  remedial  measures  for  Vdta-vy^dhi  should  be  re- 
sorted to.  We  shall,  however,  revert  to  the  subject  in 
the  Uttara-Tantra.     34. 

The  patient  should  be  made  to  drink  a  potion  of 
Sneha-Lavana*  dissolved  in  an  adequate  quantity  of 
water,    or  the  powders  of  the  Pippalyadi  group  (with  an 

*   Sneha-Lavana   has    been     described     in   Chap.     4.     (treatment    of 
Vata-vyadhi)  para.  24. 


312  THE  SUSHRUTA  SAMHITA.  [Chap.  V. 

adequate  quantity  of  water),  or  clarified  butter,  thickened 
or  saturated  with  pulverised  asafoetida  and  Yava-kshdra 
(Carbonate  of  Potass),  in  cases  of  Tuni  and  Prati-tuni. 
Applications  of  Vastis  should  also  be  resorted  to.     35. 

In  a  case  of  Adhmaina  (Tympanites),  the  remedy 
should  consist  in  the  applications  of  powders  of  the 
Dipaniya  (appetising)  group,  of  suppositories  (Phala-varti), 
Vastis  and  digestive  drugs  (Pachaniya  group).  The 
patient  should  also  be  advised  to  observe  a  rigid  fast 
and  his  abdomen  should  be  fomented  with  hot  palms. 
After  that  he  should  break  his  fast  with  boiled  rice  pre- 
pared with  appetising  (Dipana)  drugs  such  as,  Dhanyaka, 
Jiraka,  etc.  Similarly,  a  case  of  Pratyafcdhmaina  should 
be  treated  with  fasting,  emetics  and  appetising  drugs. 
Cases  of  Ashthilat  or  Pratyashthilai  should  be  treated 
as  a  case  of  Gulma  and  internal  abscess,  to  all  intents 
and  purposes.     36-38. 

Hingvadi-Vati  :  — A  compound  consisting  of 
asafoetida,  Trikatu,  Vachd,  Ajamodd,  Dhanyd,  Aja- 
gandhd,  Dddimba,  Tiniidi,  Patha,  Chitraka,  Yava-kshara, 
Saindhava  salt,  Vid  salt,  Sauvarchala  salt,  Svarjikd- 
kshdra^  Pippali-mula,  Amla-vetasa,  S'athi^  Pushkara-mula, 
Hapushd^  Chavyd,  Ajdji  and  Pathyd,  powdered  together 
and  treated  many  times  with  the  expressed  juice  of  Mdtu- 
lunga  in  the  manner  of  Bhavana*  saturation,  should  be 
made  into  boluses,  each  weighing  an  Aksha  (two  ToUs) 
in  weight.  One  (such)  pill  should  be  taken  (in  an  empty 
stomach)  every  morning  in  all  diseases  of  the  deranged 
V^yu.  This  compound  proves  curative  in  cough, 
asthma,  internal  tumour  (Gulma),  ascites,   heart-disease, 

*  '*  Bhavana"  consists  in  soaking  a  powder  or  a  pulverised  compound 
with  the  expressed  juice  or  decoction  of  any  drugs  or  with  any  liquid  and 
in  getting  it  dry  (generally).  This  process  should  be  cotinued  many  times 
(generally  seven  times)  in  succesion. 


Chap,  v.]  CHIKITSA  STHANAM.  3x3 

tympanites,  aching  pain  at  the  sides,  in  the  abdomen 
and  in  the  bladder,  in  cases  of  an  aversion  to  food, 
retention  of  stool,  strangunary,  enlarged  spleen,  piles, 
Tuni  and  Prati-tuni.     39. 

IVIemorable  Verses  :— From  the  symptoms 

or  leading  indications,  exhibited  in  each  case  and  from  a 
close  examination  thereof,  it  should  be  inferred  whether 
the  Vayu  alone  has  been  deranged  or  whether  it  has 
combined  with  any  other  Dosha,  or  has  affected  any 
other  fundamental  principle  (Dhdtu)  of  the  organism  as 
well  ;  and  the  medical  treatment  should  follow  a 
course,  so  as  not  to  prove  hostile  to  the  Doshas  or  the 
Dha'tus  (organic  principles)  implicated  in  the  case,  in 
its  attempt  to  subdue  the  aggravated  Vdyu.  In  a 
case  of  cold,  compact  and  painful  swelling  (appearing 
in  any  part  of  the  body)  owing  to  the  combination  of 
the  deranged  Vdyu  with  fat,  the  treatment  should  be 
identical  with  that  of  a  swelling  in  general.     40-41. 

Uru-Stambha  :— The  deranged  Vdyu,  sur- 
charged with  the  local  fat  and  Kapha  gives  rise  to  a 
swelling  in  the  region  of  the  thigh  which  is  known 
as  Uru-stambha  ;  others  designate  it  as  Adhya-Vatta. 
This  disease  is  marked  by  lassitude  and  an  aching  pain 
in  the  limbs,  by  the  presence  of  fever,  horripilation  and 
somnolence  and  by  a  sensation  of  coldness,  numbness, 
heaviness,  and  unsteadiness  in  the  thighs,  which  seem 
foreign  to  the  body.     42. 

Its  Treatment  :— The  patient  should  be  made 
to  drink  a  potion  consisting  of  the  pulverised  compound 
known  as  the  Shad-dharana-yoga ;  or  of  the  drugs  con- 
stituting the  Pippallyadi  group,  dissolved  in  (an  adequate 
quantity  of)  hot  water  without  using  any  oleaginous 
substance  ;  or  a  lambative,  composed  of  pulverised 
Triphald  and  Katuka   mixed   with   honey,    should    be 

40 


314  THE  SUSHRUTA  SAMHITA.  [Chap.  V. 

used ;  or  a  potion,  consisting  of  Guggulu  or  S'ildjatu 
dissolved  in  cow's  urine,  should  be  administered.  These 
compounds  subdue  the  aggravated  Vdyu  surcharged 
with  deranged  fat  and  Kapha  and  prove  curative  in 
heart-disease,  an  aversion  to  food,  Gulma  and  internal 
abscesses.  A  medicinal  plaster  composed  of  Karanja 
fruits  and  mustard  seeds,  pasted  with  a  copious  quantity 
of  cow's  urine  should  be  applied  hot  to  the  affected  part, 
which  may  be  as  well  fomented  with  cow's  urine  mixed 
with  alkali  (Kshdra) ;  or  the  locality  should  be  sham- 
pooed with  articles  devoid  of  any  oily  substance.  The 
diet  of  the  patient  should  consist  of  old  and  matured 
Sydmaka,  Kodrava,  Udd^la  and  Sdli  rice  with  the  soup  of 
dry  Mulaka  or  Patola,  or  of  the  flesh  of  animals  of 
the  Jdngala  group  cooked  without  clarified  butter  or 
vegetables  iS^dkd)  cooked  without  salt.  The  use  of  oil 
and  of  lardaceous  substances  in  general  (Sneha-karma) 
should,  however,  be  prescribed  after  the  deranged  fat 
and  Kapha  have  (totally)  subsided.     43. 

Therapeutic  properties  of  Guggulu  : 

— Guggulu  is  aromatic,  light,  penetrating  into  the  mi- 
nutest parts  of  the  body,  sharp,  heat-making  in  potency, 
pungent  in  taste  and  digestion,  laxative,  emulsive,  slimy, 
and  wholesome  to  the  heart  (Hridya).  New  Guggulu  is 
an  aphrodisiac  and  a  constructive  tonic.  Old  GrUggulu 
is  anti-fat  and  hence  reduces  corpulency.  It  is 
owing  to  its  sharpness  and  heat-making  potency 
that  Guggulu  tends  to  reduce  the  Vdyu  and  the 
Kapha  ;  it  is  its  laxativeness  that  destroys  the  Malas 
(refuge  deposits  in  the  Srotas)  and  the  deranged 
Pitta ;  its  aroma  removes  the  bad  odours  of  the 
Koshtha  ;  and  it  is  its  subtle  essence  that  improves 
the  appetising  faculty.  Guggulu  should  be  taken 
every  morning  with  a  decoction  of  Triphald^  Ddrvi  and 


Chap.  V.J  CHIKITSA  STHANAM,  315 

Patola  or  with  that  of  Kus,'a  roots* ;  it  may  also  be 
taken  with  an  adequate  quantity  of  cow's  urine,  or  with 
alkalinef  or  tepid  water.  The  patient  should  take 
boiled  rice  with  soup,  milk,  or  extract  of  meat  after  the 
Guggulu  has  been  digested.  Diseases  such  as  internal 
tumour  (Gulma),  urinary  complaints  (Meha),  Uddvarta, 
ascites,  fistula-in-ano,  worms  in  the  intestines,  itches, 
an  aversion  to  food,  leucoderma  (Svitra),  tumour  and 
glands  (Arvuda>,  sinus,  Adhya-Vdta,  swelling  (oedema), 
cutaneous  affections  (Kushtha)  and  malignant  sores  and 
ulcers  readily  yield  to  it,  if  used  for  a  month  (with  the 
observance  of  the  regimen  of  diet  and  conduct  laid  down 
previously).  It  also  destroys  the  deranged  Vdyu  incar- 
cerated in  the  Koshtha,  bones  and  joints,  just  as  a 
thunderbolt  will  destroy  trees.     44. 

Thus  ends  the  fifth  Chapter  of  the  Chikilsita  Sthanam  in  the  Sus'ruta* 
Samhita  which  deals  with  the  medical  treatment  of  Mahd-Vafa-Vyddhi. 

*  Some  explain  that  a  third  decoction  should  be  that  of  Triphala, 
Ddrvi,  Patola  and  Kus'a  grass  taken  together.— Dallana. 

The  decoctions  may  be  prepared  separately  with  Triphala,  Darvi, 
Patola  and  Kus'a.— ^aT. 

t  Some  read  '^Kshira"  (milk)  in  the  place  of  ''Kshara"  (alkali). 


CHAPTER  VL 

Now  we  shall  discourse  on  the  medical  treatment   of 
Haemorrhoids  (A rsas).     i. 

The   remedial    measures   in   haemorrhoids    may    be 
grouped  under  four  subheads  ;  namely,  the  employment  of 
(active)  medicinal  remedies,  the  application  of  an  alkali 
(into  the  seat  of  the  disease),  actual  cauterization  (of  the 
polypii)  and  surgical  operation.     A  case  of  recent  origin 
involving  the  action  of  theDoshas  to  a  slight  degree  and 
uncomplicated  with  any  grave    or   dangerous  symptom 
and    complication    may     prove   amenable  to    medicine 
alone.    Deep-seated  polypii.  which  are  soft  to  the  touch 
and  markedly  elevated  and  extended  (external — D  R.), 
should    be    treated    with     alkaline   applications,    while 
those  which   are  rough,  firm,  thick   and  hard  should   be 
cauterized  with  fire.      Polypii  which  are  raised,  exuding 
and  slender  at   the  roots    should    be   surgically   treated. 
Hcemorrhoids  which  are  held  amenable  to  medicine  and 
are  not  visible  (to  the  naked  eye)  should  be  treated   with 
the     help     of     medicines   alone.      Now,   listen  to   the 
procedure  to   be     adopted    in   the   treatment   of    Ars'as 
which   would  require  alkaline   applications,  a   cauteriza- 
tion, or  a  surgical  operation.     2. 

Application    of   Kshara:— The   body  of 

the  patient  suffering  from  haemorrhoids,  in  the  event  of 
possessing  sufficient  strength,  should  be  anointed  and 
duly  fomented.  He  should  be  made  to  eat  warm  but 
demulcent  food  (Anna)  in  a  fluid  state  (of  a  gruel-like 
consistency)  to  alleviate  the  excessive  pain  in- 
cidental to  the  action  of  the  deranged  Vdyu.  In  a 
season    neither   too   hot   nor  too   cold,   and  when   the 


Chap.  VI.]  CHIKITSA  STHANAM.  317 

sky  is  cloudless,  he  should  be  placed  in  a  raised 
up  position  in  a  clean  and  well-equipped  place  on 
a  plain  slab  or  on  a  clean  bed  with  his  head  resting 
on  the  lap  of  an  attendant  and  the  anal  region 
exposed  to  the  sun.  In  this  position  the  waist  should 
be  made  to  elevate  a  little  and  to  rest  on  a  cushion 
of  cloths  or  blankets.  The  neck  and  the  thighs  of 
the  patient  should  be  drawn  out,  and  then  secured  with 
trappings  and  held  fast  by  the  attendants  so  as  not  to 
allow  him  to  move.  Then  a  straight  and  slender-mouthed 
instrument  (somewhat  like  the  modern  rectal  speculum^ 
lubricated  with  clarified  butter,  should  be  gently  inserted 
into  the  rectum  and  the  patient  should  be  asked  to 
strain  down  gently  at  the  time.  After  seeing  the 
polypus  (through  the  speculum),  it  should  be  scraped 
with  an  indicator  and  cleansed  with  a  piece  of  cotton  or 
linen  after  which  an  alkali  should  be  applied  to  it. 
The  exterior  orifice  of  the  instrument  should  be  closed 
with  the  palm  of  the  hand  after  this  application  and  kept 
in  that  manner  for  a  period  that  would  be  required  to 
utter  a  hundred  words. 

Then  after  having  cleansed  the  polypus,  a  fresh 
application  should  be  made  according  to  the  strength 
of  the  alkali  and  the  intensity  of  the  aggravated  Doshas 
involved  in  the  case.  Further  application  of  the  alkali 
should  be  stopped  and  the  polypus  washed  with 
fermented  rice-gruel  (Dhdnyamla),  curd-cream,  Sukta, 
or  the  juice  of  acid  fruits,  in  the  event  of  its  having 
been  found  to  have  become  a  little  flabby,  bent  down, 
and  to  have  assumed  the  colour  of  a  ripe  Jambu  fruit. 
After  that  it  should  be  cooled  with  clarified  butter 
mixed  with  Yashti-Madhu,  the  trappings  should  be 
removed  and  the  patient  should  be  raised  up  and  placed 
in  a  sitting  posture  in    warm    water  and    refreshed   with 


3l8  THE  SUSHRUTA  SAMHITA.  [Chap.  VI. 

sprays  of  cold  water,  or,  according  to  some  authorities, 
with  warm  water.  Then  the  patient  should  be  made  to 
lie  in  a  spacious  chamber,  not  exposed  to  the  blasts  of 
cold  winds  (specially),  and  advised  as  regards  his  diet  and 
regiinen  Each  of  the  remaining  polypii,  if  any,  should 
be  cauterized  with  the  alkaline  application  at  an  interval 
of  seven  days.  In  case  of  a  number  of  polypii,  those 
on  the  right  side  should  be  first  cauterized  and  then 
those  on  the  left,  and  after  that  those  on  the  posterior 
side  ;  and  lastly  those  that  would  be  found  to  be  in 
front.     3. 

Polypii,  having  their  origin  in  the  deranged  Vs^yu  and 
Kapha,  should  be  cauterized  with  fire  or  alkali  ;  while 
those,  which  are  the  outcome  of  the  deranged  Pitta  and 
vitiated  blood  should  be  treated  with  a  mild  alkali  alone. 
A  perfect  and  satisfactory  cauterization  (Samyag^- 
dagdha)  of  a  polypus  should  be  understood  from  such 
symptoms  as,  restoration  of  the  bodily  Vdyu  to  its 
normal  condition,  relish  for  food,  keenness  of  the  appe- 
tite, lightness  of  the  body  and  improvement  in  strength, 
complexion  and  pleasure.  An  over-cauterized  (Ati- 
dagdha)  polypus  gives  rise  to  such  symptoms  as, 
cracking  of  the  region  of  the  anus,  a  burning  sensation 
(in  the  affected  locality),  fainting,  fever,  thirst,  and 
pn  fuse  haemorrhage  (from  the  rectum),  and  consequent 
complications  ;  while  an  insufficiently  cauterized  (Hina- 
dagdha)  polypus  is  known  by  its  tawny  brown  colour, 
smallness  of  the  incidental  ulcer,  itching,  derangement 
of  the  bodily  Vdyu^  discomforts  of  the  cognitive  organs 
and  a  non-cure  of  the  disease.     4. 

A  large  polypus,  appearing  in  a  strong  person,  should 
be  clipped  off  (with  a  knife)  and  cauterized  with  fire. 
As  regards  an  external  polypus  full  of  extremely 
aggravated  Doshas  (Vdyu,  Pitta,   Kapha  and  blood)  no 


Chap.  VI.l  CHIKITSA   STHANAM.  319 

Yantra  should  be  used,  but  the  treatment  should  consist 
of  fomentation,  anointing,  poulticing,  immersion, 
plastering,  evacuating  measures  (Visrava),  cauterization 
with  fire  and  alkali  and  a  surgical  operation. 
Measures  laid  down  under  the  head  of  Rakta-pitta 
should  bs  resorted  to  in  cases  of  haemorrhage 
(from  the  seat  of  affection).  Remedies  mentioned 
in  connection  with  dysentery  (Atisdra)  should  be  em- 
ployed in  cases  of  a  looseness  of  the  bowels ;  whereas 
in  cases  of  constipation  of  the  bowels  oily  purgatives 
should  be  administered,  or  the  remedies  for  UdAvartta 
should  be  adopted.  These  rules  shall  hold  good  in  the 
cases  of  treating  (cauterization,  etc)  a  polypus  occurring 
in  any  part  of  the  body  whatsoever.   5. 

A  polypus  should  be  caught  hold  of  and  an  alkali 
should  be  applied  thereto  with  a  Darvi,  or  a  brush 
(Kurcha),  or  an  indicator  (Salaka).  In  a  case  of  a 
prolapsus  of  the  anus,  cauterization  should  be  made 
without  the  help  of  any  Yantra  (speculum). 

Diet  : — In  all  types  of  haemorrhoids,  the  diet 
should  consist  of  wheat  barley,  Shashtika  rice  or  S'dli 
rice,  (boiled)  and  mixed  with  clarified  butter,  to  be  taken 
with  milk,  Nimba-soup,  or  Patola-soup.  The  patient 
should  be  advised  to  take  (his  meal)  with  Vdstuka, 
Tanduliyaka^  Jivanti,  Upodikd,  As'va-vald,  tender 
Mulaka,  Pdlanka,  As  ana,  Chilli,  Chuchchu,  Kaldya, 
Valliy  or  any  other  S'dkas  (pot-herbs;,  according  to  the 
nature  of  rhe  Doshas  involved  in  the  case  Any  other 
oleaginous,  diuretic,  laxative  and  appetising  (Dipana) 
diet  possessing  the  virtue  of  curing  piles  should  also  be 
prescribed.     6. 

After  the  cauterization  of  the  polypus,  as  well  as  in 
a  case  where  no  cauterization  would  be  necessary,  the 
body  of  the  patient    should    be    anointed    with   clarified 


320  THE  SUSHRUTA   SAMHITA.  [Chap.  VI. 

butter  and    oil,   etc.,    and    measures   both   general   and 
specific   (mentioned    below    and    in  accordance  with  the 
Dosha  or  Doshas  involved)  should  be  employed    for   the 
purpose     of   improving     the    digestive    powers    and    to 
alleviate   any   aggravation    of  the    Vaiyu.       He    should 
be   made   to  drink  a  potion  consisting  of  clarified  butter 
cooked  with  the  Vdyu-subduing  and  appetising  (Dipana) 
drugs*  (Kalka    and    Kvatha)  mixed    with   the    powders 
of  Hingu,  etc.,  (described  in  the  treatment  of  Maha-Vdta- 
vyAdhl,  chapter.  V).  In  a  case  of  Pittaji-Ars'as,  clarified 
butter  prepared  by    cooking    it   with    the   drugs   of    the 
Pippallyddi  and  Bhadra-ddrvddi\  groups,  should    again 
be  cooked  with  the  decoction  of  Prithakparnyadi    group 
and  the  Kalka  of  the  Dipaniya  (Pippallyddi)  group,  and 
given  as  a  potion  to  the  patient.     In  a  case    of  haemorr- 
hoid     due     to     the     action   of    the     deranged    blood  \ 
(Rakt^rsas),  the  clarified  butter  should  be  cooked   with 
a  decoction  of  Manjishthd,   Murungi,   (D.  R.   Surangi), 
&c.,    while  in   a     case    of  one   due  to  the  action  of  the 
deranged  Kapha,  the  clarified  butter  should    be    cooked 
with     a     decoction    of     the    drugs      constituting      the 
Suras ddi  group.     The   supervening    distresses     should 
be   alleviated    by    the    remedial    measures    peculiar    to 
each  of  them .     7 . 

Cauterization  with  fire  or  with  an  alkali  or  any  surgical 

*  Such  as  the  decoction  of  the  drugs  of  the  Bhadra-datvddi  (Vayu- 
subduing)  and  Pippalyadi  (Dipaniya)  group?.  This  Ghrita  should  be 
prescribed  in  a  VsCtaja  Arsas. 

t  The  epithet  "Bhadra-darvadi-pippallyddi"  in  the  phrase  "Bhadra- 
darvadi-pippallyadi-sarpih"  seems  to  be  included  into  the  body  of  the 
text  through  an  accident.  In  our  opinion,  it  is  only  an  annotation  of  the 
phrase  **Dipaniya-Vdta-hara-siddha"  occurring  in  the  last  sentence. — Ei. 

X  The  Kalkas  of  the  Pippallyadi  group  should  also  be  taken  in  the 
preparation  of  the  two  kinds  of  medicated  clarified  butter  to  be  used  in 
Raktars'as,  and   Pittiis'as. ^Z)a//a»»a, 


Chap.  VI. J  CHIKITSA  STHANAM.  32 1 

operation  in  the  present  disease  should  be  effected  by 
introducing  the  Yantra  (speculum)  into  the  rectum  (with 
the  utmost  care,  inasmuch  as  an  error  happening  in  any 
of  these  cases  may  bring  on  impotency,  swelling  (Sopha), 
a  burning  sensation,  epilepsy,  rumbling  in  the  intestines, 
retention  of  stool  and  urine,  dysenteiy,  diarrhoea,  or  may 
ultimately  end  in  death.     8. 

Rectal  Speculum  :--Now  we  shall  describe 
the  dimensions  of  the  Yantras  (and  the  materials  of 
which  they  are  made  of).  The  instrument  may  be 
made  of  iron,  ivory,  horn  or  wood.  It  should  be  made 
to  resemble  the  teat  of  a  cow.  In  the  case  of  a  male 
patient,  it  should  be  four  fingers  in  length  and  five 
fingers  in  circumference  ;  whereas  in  the  case  of  a  female 
patient,  the  length  should  be  commensurate  with  that  of 
the  palm  of  the  hand  (of  the  same  length  as  before — 
D.  R.)  and  six  fingers  in  circumference.  The  instrument 
should  be  provided  with  two  separate  apertures  in  its 
inside,  one  for  seeing  the  interior  of  the  rectum  and  the 
other  for  applying  an  alkali,  or  actual  cautery  (Agni)  to 
the  polypus,  since  it  is  impossible  to  apply  fire  and 
alkali  through  the  same  aperture.  The  circumference 
of  the  aperture  in  the  upper  three  fingers  of  the  instru- 
ment should  be  like  that  of  a  thumb.  There  should 
be  a  bulb-like  protrusion  of  the  same  width,  at  the 
bottom,  and  above  it  a  space  of  half  a  finger's  width. 
Thus  we  have  briefly  described  the  shape  of  the 
instrument.     9-10. 

Alepa  (plasters)  :— Now  we  shall  describe  the 
plasters  to  be  applied  to  the  haemorrhoids  (to  cause 
their  spontaneous  dropping  off).  The  first  consists  of 
pulverised  turmeric  mixed  with  the  milky  exudation  of 
the  Snuhi  tree.  The  second  contains  of  the  cock- 
evacuations  and  pulverised  Gunjd,  turmeric  SLnd-Ptppa/t 

41 


322  THE  SUSHRUTA  SAMHITA.  [Chap.  Vl. 

pasted  with  the  urine  and  bile  of  a  cow.  The  third 
is  compounded  of  Danti^  Chitraka,  Suvarchikd  and 
Ldngali  pounded  together  and  made  into  a  paste  with 
cow's  bile.  The  fourth  consists  of  Pippali^  rock-salt, 
S'irisha-SQQds  and  Kushtha  pasted  with  the  milky  juice 
of  an  Arka^  or  Snuhi  plant.  An  oil  cooked  in  combina- 
tion with  Kdsisa  (sulphate  of  iron),  Haritdla  (yellow 
orpiment),  rock-salt,  As'vamdraka,  Vidanga,  Putika, 
Kritavedhana,  Jamhu,  Arka,  Uttatndrani,  Danti^ 
Chitraka,  Alarka  and  Snuhi-m\\V,  and  used  as  an 
unguent,  leads  to  the  falling  off  of  the  polypus,     ii. 

Internal  piles  :— Now  we  shall  describe  the 
remedial  measures  which  bring  about  the  falling  off  of 
the  invisible  (internal)  haemorrhoids.  The  patient  should 
take  Haritakl  with  treacle  every  morning  ;  or  a  hundred 
Haritakis  should  be  boiled  in  a  Drona  measure  of  cow's 
urine  and  the  patient,  observing  a  strict  continence, 
should  take  with  honey  every  morning  as  many  of  them 
as  suit  his  constitution  ;  or  he  should  be  made  to 
take  every  day  a  paste  made  of  the  roots  of  Apdmdrga 
with  the  washings  of  rice  and  with  honey.  S'atdvari 
pasted  with  an  adequate  quantity  of  milk  or  ;a  Karsha 
measure  of)  the  powders  of  Chitraka  mixed  with  a  copious 
quantity  of  good  Sidhu  wine,  or  a  gruel  (Mantha) 
(neither  extremely  thick  nor  thin),  or  powdered  barley 
or  wheat  mixed  with  Takra  and  Bhalldtaka  powder, 
should  be  administered  without  any  salt.  A  quantity  of 
Takra  should  be  kept  in  an  earthen  pitcher,  plastered 
inside  with  a  paste  of  Chitraka  roots,  and  given  to 
the  patient  in  food  and  drinks  whether  fermented  or 
not,  A  Takra  should  also  be  separately  prepared  as  in 
the  preceding  manner  with  Bhdrgi^  Asphotd,  barley, 
Amalaka  and  Guduchi  and  administered  similarly  ;.  this 
is  called  the  Takra-kalpa  (butter-milk  compound).     12. 


Chap.  VI.3  CHIKITSA  STHANAM.  323 

A  medicated  Takra  should  also  be  prepared  with 
Pippali^  Pippali-mula,  Chavya^  ChiU'aka^  Vidanga, 
S'unthi  and  Haritaki^  in  the  manner  described  above, 
(and  given  to  the  patient),  who  should  abstain  from 
taking  any  solid  food,  but  live  only  on  (this)  Takra  for  a 
period  of  one  full  month  ;  or  he  should  be  given  milk 
boiled  with  a  decoction  of  S'ringavera,  Punarnavd  and 
Chitraka,  or  a  condensed  decoction  (Phdnita)  of  the 
bark  of  Kutaja  roots  mixed  with  an  after-throw  of  the 
powdered  drugs  of  the  Pippalyddi  group  and  honey. 
The  patient  should  be  made  to  partake  of  the  medicinal 
compound  known  as  the  Hingvadi-churua,*  described 
in  the  chapter  on  Maha-Vdta-vyddhi,  and  be  made  to 
live  either  on  milk,  or  on  Takra.  As  an  alternative,  he 
should  take  Kulmdsha  boiled  in  Kshdrodaka  (alkaline 
water)  prepared  from  Chitraka-voois  and  made  saline 
with  a  liberal  after-throw  of  Yava-kshdra ;  or  he  should 
take  milk  boiled  with  the  Kshdrodaka  (alkaline  water) 
prepared  from  Chitraka-roots,  or  Kulmasha  boiled  with 
the  alkaline  water  prepared  from  the  ashes  of  burnt 
P  aids  a  ;  or  he  should  drink  frequent  potions  of  clarified 
butter  mixed  with  the  alkali  made  of  the  ashes  of  either 
Patola,  Apdmdrga,  Vrihati,  or  Paldsd  wood  ;  or  drink 
Takra  mixed  with  the  Kalka  of  the  roots  of  Kutaja  and 
of  Vanddka  ;  or  take  the  alkaline  water  of  Putika 
mixed  with  a  Kalka  of  Chitraka,  Putika  and  Ndgara  ; 
or  use  the  clarified  butter  boiled  in  an  alkaline  solution-f- 
with     the   powdered    drugs    of    the   Pippalyddi  group, 

*  In  a  preponderance  of  Vayu  and  Kapha,  Takra  should  be  taken  as 
diet ;  whereas  milk  should  be  taken  in  a  case  of  the  preponderance  of 
vitiated  blood. 

t  During  the  period  when  the  above  mentioned  alkaline  preparations 
are  used,  the  diet  of  the  patient  should  consist  of  clarified  butter,  milk 
and  meat-soup  for  fear  of  the  loss  of  the  Ojo-Dhatu, 


324  THE  SUSHRUTA   SAMHITA.  [Chap.  VI. 

added  to  it  by  way  of  an  after-throw ;  or  he  should  take 
every  morning  one  or  two  Palas  of  black  sesamum 
(according  as  required),  with  cold  water.  These 
measures  prove  remedial  in  cases  of  haemorrhoids  and 
tend  to  improve  the  digestion.     13. 

Dantyarishta  :  — A  Tula   weight*  (twelve  seers 

and  a   half)   of  the   following   drugs,   ziz.,   Das'a-mula, 

Danti,  Chitraka   and    Hai'itaki  should    be    boiled    with 

four  Drona  measures  of  water  till  reduced  to  one  quarter 

part  (one  Drona).     The  decoction,  thus  prepared,  should 

be  cooled  down,  filtered,  mixed  with  a  Tuld    measure  of 

treacle  and  preserved  into  a  receptacle   which   formerly 

contained     clarified     butter,     which     should     then    be 

kept     buried    for   a    month    in    a    heap  of    unthrashed 

barley      At   the   close   of    this  period  an  adequate  dose 

of  this  preparation     should     be     given    to   the    patient 

every     morning.      This    medicine   proves   beneficial    \n 

cases    of     haemorrhoids,    chronic     diarrhoea    (Grahani), 

jaundice,  obstinate  constipation  of  the  bowels  (Udavartta) 

and   in  an  aversion  to  food.     It  is  also  a  good  stomachic 

agent. 

AbhayariShtat  :— Two  Pala  weight  of  each 
of  the  following  drugs,  viz.,  Pippali^  Maricha,  Vidanga, 
Elavdlukd  and  Lodhra,  five  J  Pala  weight  of  Indra- 
vdruni,  ten  Pala  weight  of  the  inner  pulps  of  the  Kapittha 
fruit,  half  a  Prastha  measure  (one  Prastha  is  equal 
to  two  seers)  of  Haritaki  and  one  Prastha  weight  of 
Amalaki,  boiled  together  with  four   Drona    measures   of 

*  Some  are  of  opinion  that  one  Tula  weight  of  each  of  the  drugs 
should  be  taken  ;  but  Gayaddsa  does  not  say  so. 

t    Charaka  also  reads  this  under  the  name  of  Abhaydrishta. 

X  Experienced  physicians  recommend  two  and  a  half  Pala  weight  of 
Indra-Vdruni  in  lieu  of  five  Palas  for  its  astringent  taste.  Charaka, 
liowever,  recommends  oply  "half  a  Pala." 


Chap.  VI.]  CHIKITSA   STHANAM.  325 

water  until  reduced  to  one  quarter  of  its  quantity.  This 
decoction  should  be  filtered  (through  a  piece  of  linen) 
and  cooled  down,  after  which  two  Tula  weight  of 
treacle  should  be  added  to  it.  The  whole  preparation 
should  be  then  kept  in  a  receptacle  which  formerly 
contained  clarified  butter,  and  be  kept  buried  half  a 
month  in  a  heap  of  unthrashed  barley.  After  the  lapse 
of  the  said  period,  the  patient  should  be  made  to  drink 
(an  adequate  quantity  of)  this  preparation  every 
morning  according  to  his  strength.  This  Arishta 
proves  curative  in  cases  of  an  enlarged  spleen, 
impaired  digestion,  chronic  diarrhoea  (Grahani),  Ars'as, 
heart-disease,  jaundice,  cutaneous  affection,  ascites, 
Gulma,  oedema  (Sopha),  and  worms  in  the  intestines, 
and  improves  the  strength  and  complexion  of  the 
body.     14 

Anointing  (Sneha-karma),  fomentation,  use  of  emetics 
and  purgatives  and  the  application  of  Anuv^sana  and 
Asthcipana  measures  should  be  employed  in  cases  of 
haemorrhoids  due  to  the  action  of  the  deranged  Vaiyu*. 
The  use  of  purgatives  is  recommended  in  the  Pittaja 
type ;  soothing  or  pacifying  (Samsamana)  measures  in 
the  Raktaja  type  ;  and  S'ringavey-a  and  Kulattha  in  the 
type  caused  by  the  action  of  the  deranged  Kapha.  All 
the  preceding  remedies  should  be  combinedly  employed 
when  the  concerted  action  of  all  the  Doshas  would 
be  detected.  As  an  alternative,  milk  boiled  with  the 
proper  drugs  may  be  administered  in  every  case.     15. 

Bhallataka-yogaf  :~Now  we  shall  describe 
the  mode  of  using  Bhallattaka  in  cases  of  haemorrhoids. 

*     Some  are  of  opinion  that  the  Rishis  do  not  read  this    line.     But   as 
Gayadasa  explains  it,  so  Dallana,  he  tells  us,  also  does  the  same. 

t     A  physician  should  apply  this  medicine   after   a   due   consideration 
and  according  to  the  physical  condition  of  the  patient. 


326  THE   SUSHRUTA   SAMHITA.  [Chap.  VI. 

A  ripe  and  fresh  Bhalldtaka  should  be  cut  into  two, 
three  or  four  pieces  and  a  decoction  should  be  made  of 
them  in  the  usual  way.  The  patient  should  be  made 
to  drink  four  Tola  weight  of  this  cold  every  morning 
after  lubricating  or  anointing  his  tongue,  palate  and 
lips  with  clarified  butter,  and  should  take  his  chief 
meal  with  milk  and  clarified  butter  in  the  afternoon. 
The  number  of  Bhalldtakas  in  preparing  the  decoction 
should  be  increased  by  one  every  day  till  the  fifth 
day,  (and  the  quantity  of  the  decoction  to  be  drunk 
by  the  patient  should  be  similarly  increased).  After 
that,  the  number  of  Bhalldtakas  (and  consequently 
the  quantity  of  the  decoction  to  be  taken)  should  be 
increased  by  five  every  day.  This  method  should  be 
followed  till  the  number  of  the  Bhallatakas  reaches 
seventy,  after  which  it  should  be  decreased  every 
day  by  five  until  it  is  reduced  to  five  Bhallatakas 
only  (and  five  Sukti  measures  of  the  decoction). 
Subsequently  the  number  of  Bhallataka  (and  the  dose) 
should  be  diminished  by  one  (and  one  Sukti  measure 
respectively)  every  day,until  it  is  reduced  to  the  original 
one  (and  one  Sukti  measure).  By  taking  a  thousand 
Bhallatakas  in  this  manner,  one  may  get  rid  of  an  attack 
of  any  kind  of  Kushtha  and  Ars'as,  and,  having 
become  strong  and  healthy,  may  live  for  one  hundred 
years.  i6. 

Other  forms  of  Bhallataka-yoga  :  — 

The  oil  extracted  from  or  pressed  out  of  Bhallatakas, 
in  the  manner  laid  down  in  the  chapter  on  Dvi-vrana, 
should  be  taken  in  a  dose  of  one  Sukti  (four  Tolas)  every 
morning.  The  patient,  as  in  the  preceding  case,  should 
take  his  meal  (  of  boiled  rice,  milk  and  clarified 
butter)  after  the  digestion  of  the  oil  with  a  similar  good 
Qfifect.     As  ai)  alternative,  oil  should  be  extracted    froni 


Chap.  VI.]  CHIKITSA   STHANAM.  327 

the  marrow  of  Bhalldtakas  and  the  patient,  after  cleansing 
his  system  with  emetics  and  purgatives,  etc.,  and  regulat- 
ing his  diet  in  the  order  of  Peya,  etc.  should  enter 
into  a  spacious  chamber,  protected  from  the  blasts  of  the 
winds  and  take  two  Palas,  or  one  Pala  weight  of  the  oil 
according  to  his  strength  A  meal  of  boiled  rice, 
milk  and  clarified  butter,  etc.,  should  be  taken  after  the 
oil  had  been  fully  digested.  The  oil  should  be  conti- 
nued, in  this  way,  for  a  month,  the  regimen  of  diet 
should  be  strictly  observed  for  a  period  of  three  months 
and  the  patient  should  abstain  from  anger,  etc,  during 
this  period.  The  use  of  this  oil,  in  the  above  mentioned 
way,  not  only  ensures  a  radical  cure  of  the  disease  with 
all  its  complications,  but  would  increase  the  duration  of 
life  to  a  hundred  years  with  the  glow  of  youth  and 
health  and  with  an  increment  in  the  powers  of  memory, 
retention  and  wisdom.  The  application  of  this  oil  for 
every  one  month  will  extend  one's  life  for  a  period 
of  one  hundred  years.  In  the  same  way  a  continuous 
use  for  ten  months  would  enable  him  to  live  for  a 
thousand  years.     17. 

IVlemorabie  Verses  :-Vrikshaka  (Kutaja) 

and  Bhallattaka*  prove  as  much  curative  in  cases  of 
all  kinds  of  haemorrhoids,  as  Kshadira  and  Vijaka  are 
effective  in  cases  of  cutaneous  affections  (Kushtha). 
Cauterization  with  fire,  or  with  an  alkali,  proves  as 
much  palliative  in  cases  of  external  haemorrhoids  as 
turmeric  proves  soothing  in  those  of  Prameha.     18-19. 

Medicated  Ghritas,  appetising  drugs,  electuaries, 
medicinal  wines,  Ayaskriti  and  Asava  should  be 
prescribed  in  cases  ol  haemorrhoids,  according  to 
the    nature    and    intensity    of     the    Doshas     involved 

Boiled  with  sixteen  times  of  water  in  the    event    of   the    Bhallataka 
being  dry,  otherwise  with  eight  times  of  water  only. 


328  THE  SUSHRUTA  SAMHITA.  [Chap.  VI. 

therein.  Voluntary  suppression  of  any  natural  urgings 
of  the  body,  sexual  intercourse,  riding  on  horse-back, 
etc.,  sitting  on  the  legs  and  such  diets  as  would 
aggravate  the  Doshas,  should  be  avoided  in  cases  of 
haemorrhoids.     20-21. 


Thus  ends  the  sixth  Chapter  in  the  Chikitsita  Sthanam  of  the   Sus'ruta 
Samhita  which  deals  with  the  medical  treatment  of  Ars'as. 


i 


I 


CHAPTER  VII. 

Now  wc  shall  discourse  on  the  medical  treatment 
of  urinary  calculus,  etc.  (Asmari).     i. 

Metrical  Texts  :— Asmari  (urinary  calculus, 
etc)  is  a  dangerous  disease  and  is  as  fatal  as  death  itself. 
A  case  of  recent  origin  (acute)  proves  amenable  to 
medicines,  while  an  enlarged  or  chronic  one  requires 
surgical  operations.  The  remedial  measuies,  in  the 
order  of  anointing,  etc,  should  be  employed  in  the  first 
or  incipient  stage  of  the  disease,  whereby  the  entire 
defects  with  their  causes  {i.e.,  roots  of  the  disease)  would 
be  radically  cured.     2. 

Treatment  of  Vataja  Asmari :— Clarified 

butter  cooked  with  a  decoction  of  Pdshdnabkeda,  Vasuka, 
Vas'ira,  As'mantaka,  S'atdvari^  S'vadamstrd^  Vrihati, 
Kantakdrikd,  Kapotavamka,  A'rtagala,  Kakubha^^  Us'ira, 
Kubjaka,  Vrikshddani^  Bhalluka,  Varuna,  S' dka-phala^ 
barley,  Kulattha,  Kola  and  Kataka  fruits  and  with  the 
Kalka  of  the  drugs  constituting  the  group  of  Ushakddi, 
speedily  brings  about  the  disintergration  of  As'mari 
(urinary  calculi,  etc.)  due  to  the  action  of  the  deranged 
Vaiya.  Milk,  Yavagu  (gruel),  a  decoction,  soup,  or  an 
alkali,  properly  prepared  with  the  above  Vayu-subduing 
drugs  should  also  be  administered  as  food  and  drink 
in  the  above  cases.     3. 

Treatment  of  Pittaja  Asmari  :  —Simi- 
larly   a     medicated     clarified   butter   cooked   with   the 

*  Chakradatta  reads  "Kopotavaklra"  in  place  of  "Kapotavamka" 
"Kanchana"  in  place  of  'Kakubha"  ;  and  ''Gulmaka"  in  place  of 
"Kubjaka  "  From  an  examination  of  Dallana  it  appears  that 
• 'Kachchhaka"  is  also  a  reading  of  "Ivakubha. " 

42 


330  THE  SUSHRUTA  SAMHITA.  [Chap.  VII. 

decoction  of  Kus'a,Kds'a,  S'ara,  Gundrd,  Itkata^  Morata, 
As'mabhid,  S'atdvari^  Viddri,  Vdrdhi^  S'dli-mula,  Tri- 
kantaka,  Bhalluka,  Pdtald,  Pdthd,  Pattura,  Kuruntikd, 
Punarnavd*,  S'irisha,  with  the  paste  (Kalka)  consisting 
of  S'ildjatu,  Madhuka  (flower)  and  the  seeds  oi  Indivara\ , 
Trapusha  and  Ervdruka,  would  speedily  bring  about 
the  disintegration  of  Pittaja  As'mari  (calculi,  etc.). 
An  alkali,  Yavagu  (gruel),  soup,  a  decoction,  or  milk, 
properly  prepared  with  the  above  Pitta-subduing  drugs, 
should  also  be  prescribed  as  food  and  drink  in  these 
cases.     4. 

Treatment    of     Kaphaja    Asmari  :— 

The  use  of  medicated  clarified  butter  prepared  from 
the  milk  of  a  she-goatf  and  cooked  with  the  paste 
(Kalka)  of  the  drugs  constituting  the  Varunddi  groupj, 
Guggulu,  Eld,  Harenu^  Kushtha,  the  Bhadrddi  group, 
Maricha.  Chitraka,  Surdhvd  and  the  Ushakddi  group, 
leads  to  the  speedy  disintegration  and  expulsion  of  the 
As'mari  (stone,  etc.)  due  to  the  action  of  the  deranged 
Kapha.  So  also  the  use  of  an  alkali,  Yavdgu  (gruel), 
soup,  milk,  or  a  decoction,  properly  prepared  with  the 
above  Kapha-subduing  drugs,  is  recommended  as  food 
and  drink  in  such  cases.     5. 

A  potion  consisting  of  the  powdered  fruit  of  the  Pichuka, 
Amkola,  Kataka,  S'dka  and  /;^<^2Wr^  mixed  with  treacle§ 

*     Chakradatta  reads  "Punarnave"  i.e.^  both  the  kinds  of  Punarnava. 

t  Jejjata  explains  *'Indivara"  as  'Nilotpala.'  But  Gayadasa  does  not 
support  this. 

X  S^me  say  that  "Aja-sarpih"  is  superfluous.  Chakradatta  reads 
''■m  ^^II^l^  "^  ^^1#^l^^f*(:''  in  place  of  "^^t  ^^^if^^  ^I^^I- 
fT^?r^  ''"'  meaning  thereby  that  the  decoction  of  the  Varunadi-gana  is  to 
be  used.  Chakradatta's  reading  seems  to  be  the  correct  one  and  is 
observed  in  practice  with  good  results. — Ed. 

§  The  quantity  of  treacle,  to  be  taken,  should  be  equal  to  the  entire 
quantity  of  the  powders  ;  anci  hot  water  should  be  use4  — PaUan^^. 


Chap.  VII.]  CHIKITSA  STHANAM.  '33'r 

and  water  proves  beneficial  in  cases  of  Gravel  (Sarkard). 
The  bones  of  the  Krauncha,  camel  and  ass,  as  well  as 
the  drugs  known  as  S'vadamshtrd*  Tdlamuli^  Ajamodd^ 
Kadambaxoots  and  Ndgara  pounded  together  and  ad- 
ministered through  the  vehicle  of  wine  (Surd)  or  hot 
water,  leads  to  the  disintegration  of  Sarkara  gravel). 
The  milk  of  an  ewe  mixed  with  powdered  Trikantaka- 
seeds  and  honey  should  be  used  for  seven  days  for  the 
disintegration  and  separation  of  an  Asmari.     6-y, 

Alkaline  Treatments:— An  alkali  should  be 

prepared  from  the  ashes  of  the  drugs  used  in  the  prepara- 
tion of  the  aforesaid  medicated  clarified  butters,  by  dis- 
solving and  filtering  them  in  ewe's  urine  The  alkali  should 
then  be  slowly  boiled  with  an  alkali  similarly  prepared 
from  the  dung  of  domestic  animals,  with  the  powders  of 
Trikatu  and  the  drugs  of  the  Ushakddi  group  thrown 
into  them  as  an  after-throw.  It  proves  curative  in  cases 
of  stone,  Gulma,  and  gravel.  Alkaliesf  from  burnt  bark 
of  sesamum,  Apdmdrga^  plantain,  P  aids' a  and  barley 
taken  with  the  urine  of  an  ewe  destroy  the  gravel 
(S'arkard).  As  an  alternative,  the  alkalies  of  Pdtald  and 
Karavira  should  be  used  in  the  preceding  manner.  8-9. 
Two  Tola  (Aksha)  weights  of  the  pastes  of  S'va- 
damstrd,  Yashti-madhu  and  Brdhmi  (mixed  with  ewe's 
urine)  should  be  given  to  the  patient ;  or  the  expressed 
juice  of  the  Edakd,  S'obJidnjana  and  Mdrkava  (with  the 
said  urine)  should  be  given,  or  a  potion  consisting  of  the 
pasted  roots  of  the  Kapotavamka  with  Kanjika,  or  Sura, 
etc.,  should  be  administered.  Milk  boiled  with  the  afore- 
said drug  (Kapotavamka)  should  be  taken  by   a  patient 

*  Some  explain  it  as  **Gokshura-seeds"  and  others  as  "Markataka- 
seeds." 

t  Four  or  six  Tola  weight  of  an  alkali  should  be  dissolved  and  filterrd 
for  a  number  of  times  before  use. 


332  THE  SUSHRUTA  SAMHITA.  [Chap.  VII. 

in  case  there  is  pain  (in  urinating).  Milk  boiled  with 
Triphald  or  Varshdbhu  should  be  administered  as  a 
drink  and  a  decoction  of  the  drugs  of  the  Vira-tarddi 
group  should  be  employed  in  all  these  cases.*     lo. 

A  physician  should  have  recourse  to  the  following 
measures  (surgical  operations)  in  cases  where  the 
above-mentioned  decoctions,  medicated  milk,  alkalies, 
clarified  butter  and  Uttara-vasti  (urethral  syringe)  of 
the  aforesaid  drugs,  etc.,  would  prove  ineffective.  Surgical 
operations  in  these  cases  do  not  prove  successful  even  in 
the  hands  of  a  skilful  and  experienced  surgeon  ;  so 
a  surgical  (Lithotomic)  operation  should  be  considered 
a  remedy  that  has  little  to  recommend  itself.  The  death 
of  the  patient  is  almost  certain  without  a  surgical  opera- 
tion and  the  result  to  be  derived  from  it  is  also  uncertain. 
Hence  a  skilled  surgeon  should  perform  such  operations 
only  with  the  permission  of  the  king.     11-12. 

IVIodes  of  Surgical  Operations  :— The 

patient  should  be  soothed  (Snigdha)  by  the  application  of 
oleaginous  substances,  his  system  should  be  cleansed  with 
emetics  and  purgatives  and  be  slightly  reduced  thereby  ; 
he  should  then  be  fomented  after  being  anointed 
with  oily  unguents ;  and  be  made  to  pertake  of  a 
meal.  Prayers,  offerings  and  prophylactic  charms 
should  be  offered  and  the  instruments  and  surgical 
accessories  required  in  the  case  should  be  arranged 
in  the  order  laid  down  in  the  Agropaharaniya  chapter] 
of    the     present   work   (Sutra-sthanam,   ch.  V.).      Thej 

*  Dallana  recommends  the  use  of  Triphala  boiled  with  milk  in] 
cases  of  pain  accompanying  Plttaja  As'mari,  while  that  boiled  with] 
Varshabhu  is  advised  to  be  given  for  the  alleviation  of  pain  in  a  case  of! 
Vdtaja  or  Kaphaja  As'mari.  The  drugs  of  Vira-taradi  group  should  be] 
used  with  milk,  clarified  butter,  a  decoction,  Yavagu  (gruel),  food,  etc.,j 
and  also  for  bath,  immersion,  etc. 


Chap.  VII.]  CHIKITSA  STHANAM.  333 

surgeon  should  use  his  best  endeavours  to  encourage 
the  patient  and  infuse  hope  and  confidence  in  the 
patient's  mind.  A  person  of  strong  physique  and  un- 
agitated  mind  should  be  first  made  to  sit  on  a  level 
board  or  table  as  high  as  the  knee-joint.  The  patient 
should  then  be  made  to  lie  on  his  back  on  the  table 
placing  the  upper  part  of  his  body  in  the  attendant's  lap, 
with  his  waist  resting  on  an  elevated  cloth  cushion. 
Then  the  elbows  and  knee-joints  (of  the  patient)  should 
be  contracted  and  bound  up  with  fastenings  (S'ataka)  or 
with  linen.  After  that  the  umbclical  region  (abdomen) 
of  the  patient  should  be  well  rubbed  with  oil  or  with 
clarified  butter  and  the  left  side  of  the  umbelical  region 
should  be  pressed  down  with  a  closed  fist  so  that  the 
stone  comes  within  the  reach  of  the  operator.  The 
surgeon  should  then  introduce  into  the  rectum,  the 
second  and  third  fingers  of  his  left  hand,  duly  anointed 
and  with  the  nails  well  pared.  Then  the  fingers  should 
be  carried  upward  towards  the  rope  of  the  perineum  i.e , 
in  the  middle  line  so  as  to  bring  the  stone  between  the 
rectum  and  the  penis,  when  it  should  be  so  firmly  and 
strongly  pressed  as  to  look  like  an  elevated  Granthi 
(tumour),  taking  care  that  the  bladder  remains  con- 
tracted but  at    the  same  time  even. 

PrOg^nosiS-M.  Text  :— An  operation  should 
not  be  proceeded  with  nor  an  attempt  made  to  extract 
the  stone  (Salya)  in  a  case  where,  the  stone  on  being 
handled,  the  patient  would  be  found  to  drop  down 
motionless  (/.^.,  faint)  with  his  head  bent  down,  and  eyes 
fixed  in  a  vacant  stare  like  that  of  a  dead  man,  as  an 
extraction  in  such  a  case  is  sure  to  be  followed  by  death. 
The  operation  should  only  be  continued  in  the  absence 
of  such  an  occurrence. 

An  incision  should  then  be   made    on    the   left   side 


334  TiiK  SUSHRUTA  SAMHitA.  tChap.  Vn. 

of  the  raphe  of  the  perineum  at  the  distance  of  a  barley- 
corn and  of  a  sufficient  width  to  allow  the  free  egress  of 
the  stone.  Several  authorities  recommend  the  opening 
to  be  on  the  right  side  of  the  raphe  of  the  perineum  for 
the  convenience  of  the  operation.  Special  care  should  be 
taken  in  extracting  the  stone  from  its  cavity  so  that  it 
may  not  break  into  pieces  nor  leave  any  broken  particles 
behind  (i.e.,  inside  the  bladder),  however  small,  as  they 
would,  in  such  a  case,  be  sure  to  grow  larger  again. 
Hence  the  entire  stone  should  be  extracted  with  the 
help  of  an  Agravaktra  Yantra  (a  kind  of  forceps  the 
points  of  which  are  not  too  sharp).     13. 

Lithotomic  Operation  in  a  female  :  — 

In  a  woman,  the  uterus  (Garbhds'aya)  is  adjacent  to  the 
urinary  bladder,  hence  the  stone  should  be  removed 
by  making  an  oblique  and  upward  incision,  otherwise 
a  urine-exuding  ulcer  might  result  from  the  deep 
incision  in  that  locality.  Any  hurt  to  the  urethra 
during  the  operation  would  be  attended  with  the 
same  result  even  in  a  male  patient.  An  incision 
made  only  on  one  side  of  the  organ  in  a  disease  other 
than  that  of  stone,  baffles  all  attempts  at  healing  ; 
while  an  ulcer  incidental  to  an  incision  made  on  both 
its  sides,  should  be  deemed  incurable.  An  ulcer 
incidental  to  an  incision  made  on  either  side  of  the 
bladder  in  extracting  a  stone  might  be  healed  up,  in- 
asmuch as  medicinal  potions  and  fomentations,  etc., 
employed  for  the  healing  of  a  surgical  wound,  lead 
to  the  healing  of  the  wound  in  the  bladder  ;  secondly 
because  the  surgical  opening  is  only  made  large  enough 
for  the  extraction  of  the  stone  as  recommended  in  the 
authoritative  books  ;  and  thirdly  because  an  increase 
in  the  quantity  of  urine  contributes  to  an  increase  in 
the  size  of  the  stone  and  hence  a  slight   secretion  of  that 


Chap.  VII.]  CHIKITSA  STHANAM.  335 

fluid  or  employment   of   diuretic   Peyas,   etc.,   are   not 
attended  with  any  injurious  effects. 

Post-Surgical  IVleaSUreS  ".—After  the  ex- 
traction of  a  stone,  the  patient  should  be  made  to  sit  in 
a  Droni  (cauldron)  full  of  warm  water  and  be  fomented 
thereby.  In  doing  so  the  possibility  of  an  accumula- 
tion of  blood  in  the  bladder  will  be  prevented  ;  however 
if  blood  be  accumulated  therein,  a  decoction  of  the  Kshira- 
trees  should  be  injected  into  the  bladder  with  the  help 
of  a  Pushpa-netra  (urethral  Syringe).      14-15- 

Memorable  Verse  : — Stones  and  the  accu- 
mulated blood  in  the  bladder  would  be  speedily  expelled 
by  means  of  injecting  a  decoction  of  the  Kshira-trees 
into  it  with  the  help  of  a  Pushpa-netra  (urethral 
Syringe).     16. 

For  the  clearance  of  the  urinary  passage,  a  treacle 
solution  should  be  given  to  the  patient  ;  and  after  tak- 
ing him  out  of  the  Droni,  the  incidental  ulcer  should  be 
lubricated  with  honey  and  clarified  butter.  A  Yavagu, 
boiled  with  the  drugs*  possessed  of  the  virtue  of  cleans- 
ing or  purifying  the  urine,  and  mixed  with  clarified 
butter,  should  be  given  to  the  patient  in  a  warm  state 
every  morning  and  evening  for  three  consecutive  days. 

After  that  period  a  diet  (meal)  of  rice  well 
boiled  and  mixed  with  milk  and  a  large  quantity  of 
treacle,  should  be  given  (to  the  patient)  in  small  quan- 
tities for  ten  days  for  the  purification  of  the  blood  and 
the  secretion  of  urine  as  well  as  for  the  purpose  of  esta- 
blishing secretion  in  the  ulcer.  The  patient  should  be 
made  to  partake  of  a  diet  (of  rice)  with  the  soup  of  the 
flesh  of  Jangala  animals  and  the  expressed  juice  of  acid 
fruits  after  the  lapse  of  these  ten  days.     17. 

•     The  urine-purifying  drugs  are    the    Trina-Panchamulas,   Gokshura, 
Kasamarda,  Pashanabheda,  etc. 


336  THE  SUSHRUTA  SAMHITA.  [Chap.  VII. 

After  that  period,  the  body  of  the  patient  should  be 
carefully  fomented  for  ten  successive  days  by  applying 
any  warm  oleaginous  substance  or  with  any  warm 
medicinal  fluid  (Drava-Sveda).  As  an  alternative,  the 
ulcer  should  be  washed  with  the  decoction  of  (the 
bark  of)  the  Kshira-Vrikshas,  A  paste  of  Rodhra, 
Madhuka,  Manjishtha  and  Prapaundarika  (pounded  to- 
gether), should  be  applied  then  to  the  ulcer.  A  medicated 
oil  or  Ghrita  cooked  with  turmeric  and  the  preceding 
drugs  should  be  applied  to  the  ulcer.  The  accumulated 
blood  in  the  affected  part  should  be  removed  with  the 
help  of  a  Uttara-vasti  (urethral  Syringe).  The  ulcer 
should  be  cauterized  with  fire  in  the  manner  described 
before  in  the  event  of  the  urine  not  flowing  through 
its  natural  passage  after  the  lapse  of  seven  days. 
After  the  urine  takes  its  natural  course,  Uttara-vasti, 
Asthdpana  and  Anuvasana  measures  should  be  employed 
with  the  decoction  of  the  drugs  belonging  to  the 
Madhura-  Varga. 

A  seminial  stone  or  gravel  (S'arkard)  spontaneously 
brought  down  into  the  urinary  passage  should  be  re- 
moved through  the  same  passage.  The  urethra  should  be 
cut  open  and  the  stone  should  be  extracted  with  a  hook 
(Vadis'a)  or  any  other  instrument  in  the  case  of  its  not 
being  expelled  out  by  the  passage.  The  patient  should 
refrain  from  sexual  intercourse,  riding  on  horse  back  or 
on  the  back  of  an  elephant,  swimming,  climbing  on 
trees  and  up  mountains  and  partaking  of  indigestible 
substances  for  a  year  even  after  the  healing  of  the 
ulcer.     i8. 

Parts  to  be  guarded  in  Lithotomic 

Operations: —The  Mutra-vaha  (urine-carry ingi  and 
the  S'ukra-vaha  (semen-carrying)  ducts  or  channels,  the 
Mushka-srotas  (cords  of  the   testes),  the    Mutra-praseka 


Chap.  Vll.j  CHIKITSA  STHANAM.  337 

[urinary)  channels,  the  Sevani  (the  raphe  of  the  perineum), 
the  Yoni  (uterus,  vagina,  etc.),  the  Guda (rectum j and  the 
Vasti  (bladder)  should  be  carefully  guarded  at  the  time  of 
performing  a  lithotomic  operation.  Death  results  in  the 
event  of  the  urine-carrying  channels  being  in  any  way 
hurt  during  the  operation  owing  to  an  accumulation  of 
urine  in  the  bladder.  Similarly,  any  hurt  or  injury  to  the 
semen-carrying  ducts  at  the  time,  results  in  death  or  in 
impotency  of  the  patient ;  a  hurt  to  the  cords  of  the 
testes  begets  an  incapacity  of  fecundation  ;  a  hurt  to  the 
urinary  ducts  leads  to  a  frequent  dribbling  of  urine  ;  while 
a  hurt  to  the  Yoni  (uterus,  vagina,  etc.),  or  to  the 
raphe  of  the  perineum  gives  rise  to  extreme  pain. 
The  symptoms  which  characterise  a  hurt  to  the  rectum 
or  to  the  bladder  have  been  described  before.     19. 

Memorable  Verses:— The  surgeon  who  is 

not  well  cognisant  of  the  nature  and  positions  of  the 
Marmas  or  vulnerable  parts  seated  in  the  eight  Srotas 
(ducts)  of  the  body  such  as,  the  raphe  of  the  perineum, 
the  spermatic  cords,  the  cords  of  the  testes  and  the 
corresponding  ones  in  females  (Yoni),  the  anal  region, 
the  urinary  ducts,  the  urine-carrying  ducts,  and  the 
urinary  bladder  and  is  not  practiced  in  the  art  of 
surgery  brings  about  the  death  of  many  an  innocent 
victim.     20. 

Thus  ends   the     seventh    Chapter   of  the   Chikitsita   Sthanam  in  the 
Sus'ruta  Samhita  which  deals   with  the   treatment   of  Urinary   calculus. 


43 


CHAPTER  VIII. 

Now  we  shall  discourse  on  the  medical  treatment  of 
Fistula-in-ano,  etc.,  (Bhagandara).      r. 

The  disease  admits  of  being  divided  into  five  different 
groups,  of  which  the  two,  known  as  S'ambukavarta  and 
S'alyaja  (traumatic),  should  be  regarded  as  incurable, 
and  th^  rest  as  extremely  difficult  to  cure.     2. 

The  General    Treatment :— The  eleven* 

kinds  of  remedial  measures  commencing  with  Apatar- 
pana  up  to  purgatives  (as  described  under  the  treatment 
of  Dvi-vrana)  should  be  employed  as  long  as  any 
fistular  ulcer  would  remain  in  an  insuppurated  stage. 
The  patient  should  be  soothed  by  the  application  of 
medicated  oil,  etc.,  and  his  body  should  be  fomented  by 
immersing  him  in  a  receptacle  of  warm  water,  etc.  as 
soon  as  suppuration  would  set  in  (and  even  after  the 
ulcer  had  burst).  Then  having  laid  him  on  a  bed 
and  bound  his  hands  and  thighs  with  straps  as  des- 
cribed under  the  treatment  of  Haemorrhoid,  the  surgeon 
should  examine  closely  as  to  where  the  mouth  of  the 
fistula  is  directed,  outward  or  inward,  and  whether 
the  ulcer  itself  is  situated,  upward  or  downward.  Then 
the  whole  cavity  or  receptacle  of  pus  (sinus)  should 
be  raised  up  and  scraped  out  with  an  Eshani  (indicator 
or  probe).  In  a  case  of  inter-mouthed  fistula,  the  patient 
should  be  secured  with  straps  (as  before  described) 
and  asked  to  strain  down.  An  incision  should  then 
be  made  by  first  directing  the  indicator  when  its  mouth 
would   become   visible  from  the  outside.     Cauterization 

*     Apatarpana,    Alepa,    Parisheka,   Abhyanga,     Sveda,    Vimldpana, 
Upandha,  Pachana,  Visrdvana,  Sneha,  and  Vamana. 


\ 


Chap.  VIII.]  CHIKITSA  STHANAM.  339 

with  fire  or  an  alkali  is  a  general  remedial  measure  which 
may  be  resorted  to  in  all  the  types  of  this  disease.     3-4. 

Specific  IWeasurcs— IVI.  Texts  :- Incases 

of  the  ^ataponaka  type  all  the  small  Vranas  about 
the  anus  should  be  first  incisioned  and  the  principal  sinus 
in  the  locality  should  not  be  looked  after  until  these 
small  ones  had  been  healed  up.  The  connected  abscesses 
should  be  respectively  incisioned  on  the  external  side, 
while  the  unconnected  ones  should  not  be  opened  at 
the  same  time  in  order  that  they  may  not  run  into 
one  another  and  be  thus  converted  into  a  wide-mouthed 
ulcer.  The  urine  and  the  faecal  matter  are  found  in  each 
case  to  flow  out  of  the  cavity  of  such  a  wide-mouthed 
ulcer  ;  and  aching  pains  in  the  rectum  and  a  rumbling 
sound  in  the  abdomen,  due  to  the  action  of  the  aggrav- 
ated Vdyu,  are  experienced.  Such  a  case  is  enough 
to  confound  even  a  well-read  and  experienced  physician. 
Hence  the  mouth  of  a  fistula  of  the  Sataponaka  type 
should  not  be  opened  with  a  broad  incision. 

Forms  of  incision  :  — An  experienced  surgeon 
should  know  that  the  Ldngalaka,  Ardha-Langalaka, 
Sarvatobhadraka  and  the  Gotirthaka  forms  of  incision 
should  be  the  different  shapes  of  incision,  in  a  case  of 
a  many-mouthed  S'ataponaka.  An  incision  equal  in  its 
two  sides  is  called  the  La(ugalaka  (curvilineal),  while  the 
one  with  one  arm  longer  than  the  other  is  named  the 
Ardha-Laingalaka.  An  incision  made  in  the  region  of 
the  anus  in  the  shape  of  a  cross  (crucial)  and  a  little 
removed  from  the  raphe  of  the  perineum,  is  called  the 
Sarvatobhadraka  by  men  conversant  with  the  shapes 
of  surgical  incisions.  An  incision  made  by  inserting  the 
knife  in  one  side  is  called  the  Gotirthaka  (longitudinal). 
All  exuding  (bleeding)  channels  in  the  affected  region 
should  be  cauterized  with  fire  by  the  surgeon. 


340  THE  SUSHRUTA  SAMHITA.  [Chap.  VIII. 

A  case  of  the  ^ataponaka  type  occurring  in  a 
person  of  timid  disposition  or  of  delicate  constitution,  is 
extremely  difficult  to  cure.  Medicinal  fomentations  en- 
dowed with  the  virtue  of  arresting  secretion  and  alleviat- 
ing pain,  should  be  quickly  applied  (to  the  seat  of  the 
disease).  Fomentations  with  Kris'ard,  or  Pdyasa  (por- 
ridge), made  with  the  aforesaid  Svedaniya  (diaphoretic) 
drugs  with  a  decoction  of  the  drugs  constituting  the 
Vilvddi  group,  Vrikshddani  and  roots  of  the  castor-plant 
mixed  and  boiled  together  with  the  flesh  of  the  Ldva, 
Vishkira  (a  kind  of  bird)  and  that  of  animals  living 
in  swampy  or  marshy  land  or  aquatic  in  their  habits 
or  Grdmya  animals,  and  then  kept  in  an  oily  pitcher  and 
applied  in  the  way  of  a  Nddi-Sveda  (fomentation  through 
Nddi  or  pipe),  should  be  at  once  applied  to  the  seat  of 
the  ulcer.  Sesamum,  castor-seeds,  linseed,  iJ/<i5^^-pulse, 
barley,  wheat,  mustard-seeds,  salts  and  the  Amla-Varga 
(see  Rasa-Vijndniya  chapter)  should  be  boiled  in  a 
saucer  and  the  affected  part  or  ulcer  should  be  fomented 
therewith.  After  being  fomented,  the  patient  should 
drink  (a  potion  consisting  of)  Kushtha,  salts  (the  five 
officinal  kinds  of  salts)  Vachd^  Hingu  and  Ajamoda 
taken  in  equal  parts  and  mixed  with  (an  adequate 
quantity  of)  clarified  butter,  grape-wine  (Mdrdvika), 
K^njika  (Amla),  Surci  or  Sauviraka.*  Subsequent  to 
that,  the  ulcer  should  be  wetted  with  the  Madhuka-oW 
and  the  rectum  should  be  washed  with  medicated  oils 
which  would  alleviate  pain  due  to  the  action  of  the 
deranged  and  aggravated  Vdyu.  The  preceding 
r^^edicinal  remedies  tend  to  bring  about  the  outflow  or 
evacuations  of  stool  and  urine  through  their  natural 
channels  or  courses,  and  undoubtedly  alleviate  all 
acute  and  supervening  distresses  which  specifically  mark 

*    By  the  use  of  this  potion  the  digestive  power  is  increased. 


Chap.  Vlir.]  CHIKITSA  STHANAM.  34I 

the  progress  of  the  disease.  We  have  described  the  treat- 
ment of  a  case  of  fistula- in-ano  of  the  Sataponaka 
(sieve)  type  ;  now  listen  to  me  about  the  treatment  of 
the  Ushtragriva  (camel's  neck)  type  of  the  disease.     5. 

Treatment  of  Ushtra-griva  :— The  ulcer 

should  first  be  searched  with  a  probe  or  director  and, 
after  an  operation,  an  alkali  should  be  applied  to  it. 
To  remove  all  sloughed  off  or  sloughing  flesh  and 
membranes  cauterization  with  fire  is  forbidden.  [The 
fissures  of  pus  (sinuses)  and  sloughed  off  flesh  should  be 
first  drawn  out].  A  plaster  of  clarified  butter  and 
pasted  sesamum  should  then  be  applied  to  it,  and  the 
ulcer  duly  bandaged.  Clarified  butter  should  be  constant- 
ly applied  over  the  bandage  which  should  be  removed 
on  the  third  day.  Cleansing  or  disinfecting  (^S'odhana) 
measures  should  then  be  used  by  the  surgeon,  accord- 
ing to  the  Doshas  involved  in  the  ulcer,  and  the 
successive  healing  (Ropana)  measures  resorted  after  its 
being  properly  purified  (S'odhana).     6 

Treatment  of  ParisrsCvi :— In  a  case  of  the 

ParisrAvi  (exuding)  type,  where  there  is  bleeding  and 
secretion  from  the  ulcer,  the  sinus  and  the  cavities  of  pus 
should  be  first  removed  and  then  cauterized  with  an  alkali 
or  with  fire  by  an  intelligent  surgeon.  The  region  of  the 
anus  should  then  be  kept  wet  by  the  sprinkling  of  luke- 
warm Anu-toila  (described  in  the  chapter  on  V^ta-vy^dhi). 
Warm  plasters,  or  poultices,  mixed  with  Yavakshdra 
and  the  urine  (of  a  cow)  should  then  be  applied. 
Decoction  of  the  emetic  drugs  as  the  seeds  of  Madana, 
etc.),  should  also  be  sprinkled  slightly  on  the  affected 
part.  The  ulcer  when  found  to  be  softened  and 
nearly  free  from  pain  and  secretion  (owing  to  the 
preceding  measures)  should  be  searched  with  a  probe 
and  the  principal  sinus  should   be  cut   open   and   again 


342.  THE  SUSHRUTA   SAMHITA.  [Chap.  VIII. 

completely  cauterized  with  fire  or  with  an  alkali.  The 
incisions  should  be  made  in  the  shape  or  form  of  a 
Kharjura-patra  (leaf  of  the  date-palm),  Ardha-chandra 
(half-moon),  Chandra-chakra  (moon's  disc),  Suchi-mukha 
(needle's  mouth),  or  Avdmmukha  (with  downward  mouth). 
After  that  the  ulcer  should  be  purified  with  mild  cleans- 
ing or  disinfecting  remedies  (as  described  above)      7. 

In  the  case  of  an  infant  cauterization  with  fire  or 
with  an  alkali,  the  use  of  strong  purgatives  and  surgical 
operations  are  forbidden  in  the  case  of  the  disease 
(Bhagandara),  whether  outer-mouthed  or  inter-mouthed. 
Medicinal  remedies  calculated  to  be  mild,  though  keen 
in  their  efficacy,  should  be  used  in  such  cases.  A  plug  or 
a  Varti  in  the  shape  of  a  wick  and  made  of  powdered 
Aragvadha,  Haridrd  and  Kala,  mixed  with  honey  and 
clarified  butter,  should  be  inserted  into  the  ulcer  for 
purifying  purposes.  This  medicinal  compound  speedily 
brings  about  the  healing  of  a  sinus,  just  as  the  wind 
will  drive  away  a  cloud.     8—9 

Treatment  of  Agantuka  Bhagan- 
dara :— The  sinus  in  a  fistula  of  traumatic  origin 
should  be  carefully  cut  open  by  a  surgeon  (with  a  knife) 
and  cauterized,  according  to  the  rules  laid  down,  with 
a  red-hot  Jambvoshtha  (instrument)  or  with  a  red- 
hot  director  (SaUka).  Vermifugal  remedies  should  be 
applied  to  it,  and  measures  laid  down  in  connec- 
tion with  the  extraction  of  a  Salya  from  the  body 
should  be  carefully  resorted  to.     10. 

Treatment  of  Tridoshaja  Bhagan- 
dara : — A  case  of  Bhagandara,  due  to  the  concerted 
action  of  the  three  Doshas,  should  be  treated  without 
holding  out  any  hope  of  recovery  tot  he  patient's  people, 
or  should  be  given  up  as  hopeless.  The  measures  and 
remedies   mentioned     above     should     be     adopted     in 


Chap.  VIII.]  CHIKITSA  STHANAM.  343 

succession  in  all  types  of  Bhagandara.  In  the 
event  of  there  being  any  pain  in  it,  owing  to  the 
insertion  of  a  knife  or  to  any  other  surgical  operation, 
luke-warm  Anu-taila  should  be  applied.  As  an  alternative, 
the  drugs  possessed  of  the  virtue  of  subduing  the  de- 
ranged Vdyu  (Bhadra-ddrvddi  and  Erandadi  groups) 
should  be  boiled  in  a  pot  covered  by  a  lid  having  a 
hole  or  aperture  on  its  top  ;  then  the  patient  with  his 
rectum  anointed  with  oil,  etc.,  should  be  made  to  sit  in 
such  a  way  over  the  said  covered  pot  that  the  seat  of 
the  disease  may  be  fomented  with  the  warm  fumes 
escaping  through  that  aperture  ;  or  Nddi-sveda  should 
be  applied  to  the  affected  region  through  a  pipe  in  a 
recumbent  posture  to  alleviate  the  pain.  As  an 
alternative,  a  hot  bath  should  be  prescribed  for  the 
alleviation  of  the  pain.  Sailvana  Upanaiha  (described  in 
connection  with  the  treatment  of  Vata-vyadhi  and  that 
with  the  skins  of  the  Kadali  Mriga,  Lopaka  and  Priyaka, 
should  be  applied  to  the  affected  locality  to  subdue 
the  pain.  A  potion  of  the  drugs  or  substances  such 
as,  Trikatu,  Vachd^  Hingu,  salt  (five  kinds  of  salt)  and 
Dipyaka,  should  be  administered  with  wine,  Kdnjika, 
Sauviraka  and  Kulattha-Soup,  etc.     11-12. 

Jyotishmati^  Ldngalaki,  S'ydmd^  Danti,  Trivrit,  Tila^ 
Kushtha,  S'atdhvd,Golomi,  Tilvaka^  Giri-karnikd^Kdsisa 
and  the  two  kinds  of  Kdnchana-kshiri,  compose  the  group 
which  is  possessed  of  the  virtue  of  purifying  (afistular  sore). 
(The  decoction  of  these  substances  should  be  applied  for 
the  purification  of  the  ulcer).  The  sore  of  a  fistula  may 
be  filled  (healed^  up  by  the  application  of  (a  compound 
of)  Trivrit,  Tila,  Ndgadanti,  Manjishthd  and  rock-salt 
pasted  together  with  milk  and  honey.  A  plaster  (Kalka) 
consisting  of  Rasdnjana,  turmeric,  Ddru-kartdrd, 
Manjishthd^  Nimha  leaves,  Trivrit ^  Tejovati  and   Danti 


344  THE  SUSHRUTA  SAMHITA.         [Chap.  VIII. 

proves  curative  in  a  case  of  sinus.  The  drugs  known  as 
Kuskthuy  Trivrit^  Tila^  Danti,  Pippaliy  Saindhava^ 
honey,  turmeric,  Triphala  and  sulphate  of  copper 
(Tuttha)  are  efficacious  in  purifying  an  ulcer.     13-16. 

Oil*  cooked  (slowly)  with  Pippali,  Yashti-madhu^ 
Lodhra^  Kushtha,  Eld^Harenu,  Samangd  (Bardha-krdnti), 
Dhdtaki  flower,  Sdrivd^  the  two  kinds  of  Haridrd, 
Priyangu^  Sarja-rasa^  Padmaka,  P adrnd-kes^ ara^  Sudhd, 
Vachd.Ldngalikd,  wax,  and  Saindhava  should  be  regarded 
as  a  potent  remedy  in  healing  up  the  ulcer  and  curing 
fistula-in-ano.  This  remedy  proves  beneficial  in  cases  of 
scrofula  (Ganda-mald),  Meha,  ulcers  and  in  the  Mandala 
type  of  cutaneous  affections  as  well.  The  drugs  which 
constitute  the  Nyagrodhddi  group  are  efficacious  in  dis- 
infecting (Sodhana)  and  healing  up  an  ulcer.  A  medi- 
cated oil  or  Ghrita  prepared  with  the  preceding  drugs 
proves  curative  in  a  case  of  fistula  in-ano.  Similarly 
a  medicated  oil  duly  cooked  and  prepared  with  the  roots 
of  Trivrit,  Dantiy  Haridrd,  and  Arka,  as  well  as  with 
Vidanga,  Triphala^  milk  of  both  Snuhi  and  Arka,  honey 
and  wax  should  be  applied,  as  it  is  specifically  efficacious 
in  a  case  of  Bhagandara.     17-19. 

Syandana  Taila  :— Oil   slowly   cooked  and 

prepared  (in  the  manner  aforesaid)  with  Chitraka,  Arka 
Trivrit,  Pdthd,  Malapu  (Kakodumbara),  Karavira, 
Sudhd  (Snuhi),  Vachd,  Ldngalaki,  Saptaparna^  Suvar- 
chikd  and  fyotishmati,  is  called  the  Syandana-Taila  and 
should  be  constantly  applied  in  a  case  of  Bhagandara. 
It  is  efficacious  in  purifying,  healing  and  imparting  a 
natural  skin-colour  to  the  cicatrix.  A  learned  and 
experienced  physician  should  adopt  the  remedial 
measures  for  this  disease  according  to  the  procedure  laid 

*     Four  seers  of  oil,  one  seer  of  the  drugs  and  sixteen   seers  of  water 
should  be  taken  at  the  time  of  preparation. 


Chap.  VIIL]  CHIKITSA  STHANAM.  345 

down  under   the  treatment   of  Dvi-Vrana,  when  there 
is  any  ulcer  (vrana)  in  existence.     20, 

The  bulb-like  protrusion  above  the  hole  of  the  instru- 
ment (speculum),  mentioned  in  connection  with  the 
treatment  of  Ars'as,  should  be  removed  and  the  instru- 
ment, now  in  the  shape  of  a  half-moon,  should  be  used 
by  an  experienced  surgeon  in  the  treatment  of  a  case  of 
fistula-in-ano.  The  patient  should  refrain  from  sexual 
intercourse,  physical  exercise,  riding,  anger,  and  the  use 
of  heavy  and  indigestible  articles  of  food  for  a  full 
period  of  one  year  even  after  the  healing  up  of  the  ulcer 
in  a  Bhagandara.     21 — 22. 

Thus   ends   the    eighth   Chapter   of    the    Chikitsita    Sthanam   of  the 
Sub'ruta-Samhita  which  deals  with  the  treatment  of  Bhagandara. 


44 


CHAPTER  IX. 

Now  we  shall  discourse  on  the  medical  treatment  of 
cutaneous  affections  in  general  (Kushtha).     i. 

A  cutaneous  disease  (Twag-dosha)  originates  through 
injudicious  conduct  of  life  such  as^  partaking  of  large 
quantities  of  unwholesome  food,  or  taking  it  before  the 
previously  eaten  one  is  digested  {i.  e ,  eating  too  often), 
indulgence  in  incompatible  articles  of  fare,  voluntary- 
suppression  of  the  natural  urgings  of  the  body,  and 
improper  application  of  medicated  oil,  clarified  butter, 
or  other  lardacious  articles.  It  is  attributed  even  to  the 
dynamics  of  sinful  acts  done  by  a  man  in  this  or  in 
some  prior  existence.     2. 

Conduct   of    diet   and    regimen  :— A 

person  afflicted  with  any  kind  of  skin  disease  should 
refrain  from  taking  meat,  lard,  milk,  curd,  oil,  Kulattha 
pulse,  Mdsha  pulse,  Nishpdva,  preparations  and  modifica- 
tions of  sugarcane  juice,  acid  substances,  incompatible 
food,  meals  taken  before  the  complete  digestion  of  the 
preceding  one,  unwholesome  and  indigestible  food,  or 
food  causing  a  burning  sensation  and  some  kind  of 
internal  secretion,  day-sleep  and  sexual  intercourse,     3. 

Regulation  of  diet  and  conduct:  — 

The  old  and  matured  grain  of  S'dli,  Shashtika,  barley, 
wheat,  Koradusha^  S'ydmdka,  Udddlaka,  etc.,  boiled  and 
taken  along  with  the  soup(Supa)  or  a  decoction*  (Yusha) 

*  An  unsalted  decoction  of  any  substance  not  seasoned  with  any 
spices  whatever  is  called  Yusha,  while  the  one  salted  and  seasoned 
with  spices  is  called  Supa-  In  preparing  the  soup  of  any  pulse,  all  husks 
should  be  carefully  thrashed  out  and  the  grain  should  be  slightly  fried 
before  boiling* 


Chap.  IX.]  CHIKITSA   STHANAM.  347 

of  either  Mudga  pulse  or  Adhaki  pulse  mixed  with 
Nimba  leaves  and  Arushkara  are  wholesome  in  a  case 
of  Kushtha.  Preparations  of  any  of  the  aforesaid 
grains  may  be  taken  with  Manduka-parni^  Avalguja, 
Atarushaka  and  Rupikd  flowers  cooked  in  mustard  oil  or 
clarified  butter,  or  with  the  soup  prepared  of  the  articles 
of  the  Tikta-varga  (bitter  group,  mentioned  in  the  Sutra- 
sthdnam).  The  cooked  flesh  of  Jdngala  animals,  devoid 
of  all  fatty  matter,  should  be  given  to  a  patient, 
habituated  to  the  use  of  meat  diet.  The  medicated  oil, 
known  as  the  Vajraka-Taila  should  be  used  for  anoint- 
ing the  body.  A  decoction  of  the  drugs  of  the  Arag- 
vadhddi  group  should  be  used  for  rubbing  (Utsadana) 
purposes.  Decoctions  of  Khadira  should  be  employed 
in  drinks,  baths,  washes,  etc.  The  preceding  rules  are 
intended  to  regulate  the  diet  and  regimen  of  one  suffer- 
ing from  Kushtha  (cutaneous  affections).     4. 

Preliminary  Treatment :— in  the  premo- 

nitary  stages  of  the  disease  the  system  should  be 
cleansed  by  the  application  of  both  emetics  and  pur- 
gatives. When  the  disease  is  found  to  invade  the 
Tvak*  only,  a  plaster  prepared  of  the  purifying  drugs 
should  be  applied  to  the  affected  parts  ;  blood-letting 
and  the  use  of  medicinal  decoctions  and  purifying  and 
disinfecting  plasters  are  the  remedies  to  be  employed 
when  the  desease  would  appear  to  infect  the  blood. 
The  same  remedies  and  Arishta,  Mantha,  Pras'a,  etc  , 
should  be  employed  when  the  disease  would  be  found 
to  have  invaded  the  principle  of  the  Matmsa  (muscles). 
Palliation  and  temporary  respite  are  the  only  cure  that 
can  be  offered  in  a  case  of  the  sin-begotten  typef  of  the 

*     Tvak  here  means  Rasa  or  serum. 

t     The  type  of   Kushtha   affecting    the    principle   of  Medas   (fat)   is 
generally  supposed  to  be  sin-begotten. 


348  THE   SUSHRUTA  SAMHITA.  [Chap.  IX. 

disease  which  is  the  fourth  (in  order  of  enumeration)  and 
that  even  is  purely  contingent  on  the  willingness  and 
capacity  of  the  patient  to  conform  to  a  strict  regimen  of 
diet,  conduct  and  dress.  Blood-letting  and  purifying 
measures  (emetics  and  purgatives)  should  be  resorted  to 
in  such  a  case  and  then  the  special  medicinal  remedies 
prepared  from  BhallsLtakaf,  Silaijatu,  Gugguln,  Aguru, 
Tuvaraka,  Khadira,  and  Asana  and  the  Ayaskriti 
should  be  used  in  accordance  with  the  prescribed  ; rules. 
The  disease  in  its  fifth  form  (is  found  to  invade  the 
bones  and)  should  be  given  up  as  incurable.     3-6. 

Treatments   of  Doshaja  Types  :— in 

the  first  stage  of  Kushtha,  the  patient  should  be  treated 
in  accordance  with  the  prescribed  maxims  (rules)  of 
Sneha-pana.  In  a  case  of  Vattaja-Kushtha,  cil  or 
clarified  butter,  cooked  with  (a  decoction  and  Kalka  of) 
Mesha-s'ringi,  S'wadamshtrd,  S'arngashtd,  Guduchi 
and  the  drugs  included  in  the  group  of  Das'anmla 
should  be  used  as  drink  and  ointment.  In  cases 
of  the  Pittaja  type,  the  patient  should  be  made  to 
drink  (a  potion  consisting  of)  clarified  butter  prepared 
with  (a  decoction  and  Kalka  of)  Dhava^  As'vakarna^ 
Kakubha,  Palds'a^  Pichu-mardha,  Parpataka,  Madhuka, 
Rodhra  and  Sainangd.  In  the  Kaphaja  type,  clarified 
butter  cooked  with  (a  decoction  and  Kalka  of)  Piydla, 
S' ditty  Aragvadha,  Nimha,  Saptaparna,  Chitrakay 
Maricha,     Vacha   and   Kushtha   should   be   prescribed. 

*  Bhallataka-preparations  have  been  described  in  the  treatment  cf 
Ars'as,  preparations  of  S'ilajatu,  Guggulu,  Aguru  and  Tuvaraka  in  the 
treatment  of  Prameha-pidaka,  and  Khadira,  Asana  and  Ayaskriti  prepara- 
tions  in  the  treatment  of  Maha-kushtha. 

t  Oil  should  be  used  in  a  case  of  Kapha-predominance,  whereas 
clarified  butter  in  that  of  Pitta-predominance.  Others  assert  that  clarified 
butter  should  be  used  for  drinking  purposes  and  oil  for  anointments. 


Chap.  IX.]  CHIKITSA   STHANAM.  349 

The  clarified  butter  cooked  with  (a  Kalka  and  a  decoc- 
tion of  I  Bhalldtaka.Ahhayd  and"  Vidanga^  or  (the  medicinal 
oils  known  as)  the  Tuvaraka  Taila  and  the  Bhallitaka 
Taila  should  be  used  in  all  types  of  Kushtha.     7-8. 

The    IVIaha-tikta  Ghrita:-A    paste    or 

Kalka  should  be  made  by  pounding  equal  parts  of 
Saptaparna^  Aragvadha,  Ativishd^  Pdthd,  Katu-rohini, 
Amritd,  Trip/iald,  Paiola,  PicJiu-marda,  Parpataka^ 
Durdlabhd,  Trdyamdjid^  Mustd,  Chandana,  Padmaka^ 
Haridrd,  Upakulyd,  Vis'dld,  Murvd,  S'atdvari,  S'drivd^ 
Indra-yava^  Atarushaka,  Shadgranthd  {I'achd),  Mad/iuka, 
Bhu-ni7nha  and  Grishtikd*,  This  paste  (Kalka)  should  be 
cooked  with  four  times  its  own  weight  of  clarified  butter, 
with  the  juice  of  Amalaka,  weighing  twice  as  much  as  the 
clarified  butter  and  with  water  weighing  four  times  the 
quantity  of  the  Amalaka  juice.  It  should  be  constantly 
stirred  (with  a  ladle),  while  being  cooked.  This  medi- 
cated Ghrita  is  called  the  Maha(-tikta  Ghrita,  which 
proves  curative  in  Kushtha,  chronic  fevers,  haemorrhage, 
heart-disease,  insanity,  ApasmAra,  Gulma,  postular 
eruptions,  menorrhagia,  goitre,  scrofula,  elephantiasis, 
jaundice,  erysipelas,  impotency,  itches  and  Pdma,  etc.   9. 

The   Tikta-Sarpih  :— Two  Pala   weight  of 

each  of  the  following  drugs,  viz.,  Triphald,  Patola,  Pichu- 
marda,  Atanishaka,  Katu-rohini,  Durdlabhd^  Trdyamdnd 
and  Parpataka-\  should  be  taken  and  boiled  together  in 
a  Drona  measure  of  water.  The  boiling  should  be 
continued  till  it  is  reduced  to  one  fourth  of  its  original 
quantity.  Then  half  a  Pala  weight  of  each  of  the 
following  drugs,  viz.,  Trdyamdnd,  Musta,  Indra-yava,  (red) 

*  Chakradatta  does  not  read  "Grishtika"  but  read  "Us'ira"  instead. 
He  also  takes  both  the  kinds  of  "Haridrd,"  of  "Upakulya"  (Pippali)  and 
of  **Sariva". 

t    Chakradatta  reads  ''Nis'a"  in  addition  to  the  above  drugs. 


350  THE  SUSHRUTA   SAMHITA.  [Chap.  IX. 

Chandana,  Kirdta  and  Pippali  should  be  pasted  together. 
This  pasted  Kalka  and  the  decoction  should  be  cooked 
with  a  Prastha  measure  of  clarified  butter.  The  medicated 
Ghrita  thus  prepared  is  called  the  Tikta-Sarpih.  Dis- 
eases such  as  Kushtha,  chronic  fever,  Gulma,  Haemor- 
rhoids^ GrahanI,  edema,  jaundice,  erysipelas  and  impo- 
tency  readily  yield  to  the  curative  efficacy  of  this 
Ghrita.     lo. 

Medicinal    Plasters  for  Kushtha  :— 

Having  first  soothed  the  patient  with  any  of  the  pre- 
ceding medicated  clarified  butters  and  having  his  body 
fomented,  the  surgeon  should  have  recourse  to  the  veni- 
section. One,  two,  three,  four,  or  five  s  iras  (veins)  of  the 
patient  may  be  opened  (according  to  the  circumtances). 
The  raised  or  elevated  patches  on  the  skin  should  be 
scraped  off,  or  should  be  kept  constantly  covered  with  a 
medicinal  plaster.  As  an  alternative,  the  characteristic 
patches  of  the  disease  should  be  first  rubbed  with 
the  substance  known  as  the  Samudra-phena  or  with  the 
leaves  of  S'dka^  Goji,  or  Kdkodumbara  and  a  plaster 
(Lepa)  composed  of  Ldkshd,  Sarja-rasa,  Rasdnjana, 
Prapunndda,  Avalguj'a,  Tejovati  and  the  roots  of 
As'va-mdraka,  Arka,  Kutaja,  and  Arevata,  pasted  with 
the  urine  or  bile  of  a  cow,  should  be  applied  to  them;  or 
Svarjikd,  sulphate  of  copper,  sulphate  of  iron,  Vidanga, 
Agara-dhuma,  Chitfaka,  Katuka,  Sudhd,  turmeric  and 
Saindhava  pounded  together  with  the  urine  or  bile  of  a 
cow  should  be  applied  to  the  diseased  localities. 

As  an  alternative,  the  alkali,  prepared  from  the  ashes 
of  Palds'a  wood  in  the  prescribed  manner,  should 
be  boiled  with  the  powders  of  the  preceding  drugs  ;  it 
should  be  removed  from  the  oven  after  reducing  it  to 
the  thickness  or  consistency  of  a  Phdnita  and  used  in 
plastering  (the  diseased  patches)  ;  or  a  plaster  composed 


Chap.  IX.]  CHIKITSA   STHANAM.  35t 

of  fyotishka  fruits,  Ldkshd,  Maricha^  Pippali  and  the 
leaves  of  the  Jdti  flower  pasted  together  ;  or  a  plaster 
composed  of  yellow  orpiment,  Manali-s'ild,  the  milky 
juice  of  Arka^  sesamum,  S'igru  and  Maricha,  pasted 
together  ;  or  a  plaster  composed  of  Svarjikd^  KushtJia, 
sulphate  of  copper,  Kiitaja,  chitraka,  Vidanga,  Maricha 
^XiAManah-s'ild  pasted  together  ;  or  a  plaster  of  Haritaki, 
Karanjikdj  Vidanga^  white  mustard  seeds,  rock-salt,  Goro- 
chand,  Somardji  and  Haridrd  pasted  together  should  be 
applied  to  the  diseased  localities. 

IVIetrical  Text:— The  preceding  seven  medi- 
cinal plasters  are  possessed  of  the  virtue  of  destroying 
or  curing  Kushtha  in  general.  Now  hear  me  deal  with 
the  remedies  to  be  specifically  employed  in  cases  of 
ringworm  (Dadru)  and  leucoderma  (Svitra\     1 1 . 

Treatment  of  Dadru  :  -  h  plaster  composed 

of  Kushthuy  mustard  seeds,  S'ri-niketa,  Haridrd,  Trikatu 
and  the  seeds  of  Chakra-marda  and  of  Mulaka  pasted 
together  with  Takra  (butter  milk  ?)  should  be  applied  to 
the  ringworm.  The  disease  is  found  to  readily  yield 
to  the  curative  efficacy  of  a  medicinal  plaster,  composed 
of  Saindhava,  Chakra-marda  seeds,  treacle,  Kes'a7'a 
(Vakula),  and  Td^-ksha-s' aila  (Rasanjana) pasted  together 
with  expressed  Kapittha  juice.  Preparations  of  Hema- 
kshiri,  Vyddhi-ghdta  (Aragvadha\  S' iris  ha,  Nimba, 
Sarja,  Vatsaka  and  Aja-karna  (a  species  of  Sarja)  should 
be  used  in  cases  of  ringworm  of  a  virulent  type  for 
baths  (D.  R.  Drinks),*  plasters  and  rubbing.     12. 

Treatment  of  ^vitra  :— In  cases  of  sVitra 

and  Pundarika,  the  patient  should  be  made  to  drink  a 
lukewarm   decoction  prepared  with  equal    parts   of    the 

*  In  drinks  or  baths,  a  decoction  should  be  used  and  in  plasters  and 
rubbings  the  ingredients  should  be  pasted  with  Takra  and  the  expressed 
juice  of  Kapittha. 


352  THE  SUSHRUTA  SAMHITA.  [Chap.  IX. 

roots  of  Bhadrd  (Udumbara)  and  Malapu,  The  use 
of  this  potion  would  produce  blisters  on  the  patches. 
These  blisters  should  be  treated,  after  their  bursting, with 
a  plaster  (Pralepa)  composed  of  the  ashes  of  the  burnt 
skin  of  leopards  and  elephants  and  made  into  a  thin 
paste  with  (mustard)  oil.  A  plaster  composed  of  the 
insect  known  as  the  Puti  and  the  Kshara  (alkali)  of 
Aragvadha  should  be  found  to  be  the  best  remedy  for 
Svitra.      13. 

All  kinds  of  Svitra  are  found  to  readily  yield  to  the 
application  of  a  medicinal  plaster  made  of  the  black 
ashes  of  a  well-burnt  cobra  (Krishna-Sarpa)  pasted  with 
the  oil  of  Vibhitaka.  The  white  ashes  of  the  said  cobra 
mixed  with  one  andahalf  timeof  its  own  weight  of  water 
should  be  filtered  seven  times  in  the  manner  of  preparing 
an  alkali.  Mustard  oil*  should  be  cooked  with  this 
alkaline  water  weighing  four  times  as  much.  An  appli- 
cation of  this  oil  proves  curative  in  cases  of  Svitra.     14. 

The  Prapunndda  seeds.  Kushtha  and  Yashti-jnadJiu 
should  be  pasted  together  with  clarified  butter.  The 
plaster  thus  prepared  should  be  given  to  a  domestic 
white  cock,  purposely  kept  without  food  for  a  day  and 
a  half  when  it  would  evince  any  sign  of  hunger  after  the 
period.  The  dung  of  the  said  cock  should  then  be 
collected  after  a  full  digestion  of  the  said  medicated 
drugs  and  applied  as  plasters  on  the  affected  patches  for 
a  month.  It  would  bring  about  the  cure  (even)  of 
internalf  Svitras.     15. 

Well  burnt  ashes  of  the  dung  of  an  elephant];,  mixed 

*    This  is  the  best  medicine  for  curing  S'vitra. 

t  The  internal  S'vitras  are  those  under  the  blisters  produced  by  the 
application  of  the  remedy  mentioned  first  in  the  list. 

X  S'ivadasa,  the  commentator  of  Chakradatta,  says  that  some  read 
g^^?p§^  in  place  of  ijsi^?^?  in  which  case  it  would  mean  "S'amatha." 


Chap.  IX.]  CHIKITSA  STHANAM.  353 

with  elephant's  urine,  should  be  filtered  several  times 
(twenty-one  times  or  seven  times)  after  the  manner  of  an 
alkaline  preparation.  A  Drona  measure  of  this  alkaline 
solution  should  be  boiled  with  the  seeds  of  the  Somardji 
weighing  a  tenth  part  thereof.  This  compound  should 
be  taken  down  from  the  oven  as  soon  as  it  assumes 
a  glossy  hue  and  should  then  be  made  into  boluses. 
Having  rubbed  the  diseased  patches  of  Svitra,  a 
plaster  of  these  boluses  should  be  applied  to  them 
which  would  soon  assume  a  healthy  and  natural  com- 
plexion.    16. 

The  leaves  and  bark  (Dala  tvacham)  of  the  Antra 
(mango)  and  the  Haritaki*  should  be  well  soaked  in  a 
decoction  of  the  same  drugs  (after  the  manner  of  a 
Bhavand-saturation)  and  made  into  Vartis  {i,e.^  plugs). 
These  Vartis  should  again  be  well  soaked  in  the  milky 
exudation  of  the  Vata  tree  and  lighted  (with  mustard  oil) 
in  a  copper  vessel  used  as  an  Indian  lamp.  The  lamp 
black,  thus  produced,  should  be  collected  and  well 
soaked  in  a  decoction  of  Haritaki.  Kildsa  (a  particular 
kind  of  Kushtha)  is  destroyed,  if  rubbed  with  this 
preparation  for  several  times  after  having  been  lubri- 
cated with  mustard  oil.f     17. 

*  According  to  some,  both  the  leaves  and  bark  of  the  "Amra"  and 
of  the  "Haritaki"  should  be  taken. 

t  The  leaves  and  bark  respectively  of  the  A'tnra  and  the  Haritaki 
should  be  taken  in  the  preparation.  The  whole  stanza  seems  to  be  of  faulty 
construction.  Dallana,  in  his  commentary,  says  that  some  read  the  fourth 
line  as  "<f^^  f%w  ^^ifT  ^EW?WT^^t^^tf%  ^Ilf^^  ll''  This  seems  to 
be  a  better  reading.  It  removes  the  difficulty  in  the  construction,  but  it 
omits  also  the  word  "KilsCsa"  from  the  text.  This,  however,  is  also  an 
improvement,  inasmuch  as  this  preparation  seems  to  be  a  remedy  for 
Svitra  (which  is  only  a  variety  of  Kilasa)  like  the  preceding  and  the 
following  ones  ;  and  it  seems  unlikely  that  Sus'ruta  would  introduce  a 
remedy  for  KilsCsa  in  general  in  the  special  treatment  of  S'vitra. 

45 


354  THE  SUSHRUTA  SAMHITA.  [Chap.  IX. 

A  case  of  leucoderma  would  (undoubtedly)  yield  to 
the  curative  virtue  of  a  medicinal  plaster  composed 
of  Somardji  seeds,  Mdkshika,  Kdkodumhara,  Ldkshd, 
powdered  iron,  Pippali  and  Rasdnjana^  taken  in  equal 
parts  and  black  sesamum  equal  to  their  combined 
weight,  pasted  with  the  bile  of  a  cow  and  applied  to  the 
diseased  patches.  Similarly,  a  case  of  ^vitra  would 
prove  amenable  to  the  application  of  peacock's  bile,  or 
of  burnt  Hrivera  mixed  with  the  said  bile.     i8. 

Various  types  of  Svitra  are  cured  with  the  appli- 
cation of  either  of  the  two  following  medicinal  plasters. 
The  first  consists  of  Jw////^  (sulphate  of  copper),  Haritdla 
(yellow  oxide  of  arsenic),  Katukd,  Trikatu^  Simha  (Rakta- 
Sobhdnjana),  Arka^  Karavira,  Kushtha^  Avalguja^  Bhal- 
Idtaka,  Kshirini^  mustard  seeds  and  Snuhi ;  and  the 
second  consists  of  the  leaves  of  the  Tilvaka,  Arishta 
(Nimba),  Pilu  and  Aragvadha  pasted  together  with  the 
seeds  of  the  Vidanga  and  Karavira  and  Haridrd^  Ddru- 
haridrd,  Vrihati  and  Kantakdri.     19. 

Nila-Ghrita  \~-Vdyasi,  Phalgu  and  Tiktd  each 
weighing  one  hundred  Palas,  two  Prastha  measures  of 
powdered  iron,  three  Adhaka  (eight  seers)  measures  of 
Triphald  and  two  Adhaka  measures  of  Asana  should  be 
boiled  together  with  three  Drona  measures  of  water.  This 
decoction  should  be  taken  down  when  reduced  to  one 
quarter  of  its  original  measure  and  cooked  again  with  a 
quantity  of  clarified  butter  (weighing  a  quarter  part  of 
the  former  (decoction)  and  with  a  Kalka  consisting  of 
Indra-yava,  Trikatu^  Tvak,  Deva-ddru^  Aragvadha,  Pdrd- 
vata-padiy  Danti,  Vdkuchi^  Kes'atdhva  (Vakula)  and 
Kantakdri.  The  patient  should  be  made  to  drink  this 
medicated  clarified  butter  when  the  disease  would  be 
found  to  have  attacked  the  Dhattus  (fundamental  prin- 
ciples of  the  organism),  or  to  have  become  involved  in  the 


Chap.  IX.  1  CHIKITSA  STHANAM.  355 

aggravated  Doshas  of  the  system.  The  diseased  patches 
should  be  rubbed  with  it,  in  the  event  of  the  afifection 
being  found  to  be  confined  to  the  Tvak  (skin)  alone. 
Even  the  type  of  Kushtha,  commonly  held  to  be  incur- 
able, has  been  found  to  prove  amenable  to  the  use  of 
this  medicated  clarified  butter,  which  is  known  as  the 
Nila-Ghrita.     20. 

IVIahsC-Nila-Ghrita  :-A    Tuld*  weight   of 

the  drugs  known  as  Triphald^  Tvak,  Trikatu,  Suras d, 
Madayantikd,  Vdyasi  and  Aragvadha  and  ten  Pala 
weights  of  each  of  the  drugs  known  as  Kdkamdchi, 
Arka,  Varuna,  Danti,  Kutaja,  Chitrakay  Ddru-haridrd 
and  Kantakdri  should  be  boiled  together  with  three 
Drona  measures  of  water.  This  decoction,  boiled  down 
or  reduced  to  six  Prastha  measures,  should  be  again 
boiled  with  the  watery  secretion  of  cowdung,  cow's 
urine,  milk,  curd  and  clarified  butter,  each  weighing  an 
Adhaka,  and  with  the  Kalka  (weighing  one-fourth  as 
much  of  clarified  butter)  of  Bhu-nimba,  Trikatu^ 
Chitraka,  Kardnj'a-huit,  Nilikd,  S'ydmd,  Avalguja,  Pilu^ 
Nilini  and  Nimba-^o'WQ.rs,  It  is  a  curative  for  Kushtha. 
The  rubbing  of  the  diseased  patches  with  this  Ghrita 
imparts  a  healthy  and  natural  colour  to  the  skin  in 
cases  of  Svitra  or  white  leprosy.  It  also  cures  diseases 
like  fislula-in-ano,  worms  in  the  intestines  and  Arsas. 
It  is  known  as  the  Mahat-Nila-Ghrita.f    21. 

A    compound    consisting   of  cow's    urine,    Chitraka^ 
Trikatu  and  honey  should  be  kept  for  a   fortnight   in    a 

•  A  Tula  is  equal  to  a  hundred  Palas  or  twelve  seers  and  a  half  of 
our  modern  measure. 

t  Dallana,  in  his  commentary,  says  that  the  two  Ghritas  (Nila  and 
Mahd-Nila)  seem  to  be  spurious  (Anarsha).  But  he  has  included  them 
in  his  commentary  as  Jejjata  and  Gayaddsa  have  read  and  explained 
them  before  him. 


356  THE  SUSHRUTA  SAMHITA.  [Chap.  IX. 

closed  earthen  pitcher  which  formerly  contained  clarified 
butter.  A  Svitra-patient  would  do  well  to  take  this 
medicine  after  this  period.  He  should  also  observe  the 
rules  of  diet  and  regimen  of  a  Kushtha-patient.  The 
application  of  a  Lepa  (medicinal  plaster),  prepared  by 
pasting  the  tender  twigs  of  the  Putika^  Arka,  Snuhi, 
Aragvadha  and  of  the  fdti  flower  with  cow's  urine,  would 
prove  curative  in  cases  of  Svitra,  ringworm,  ulcer,  bad 
types  of  haemorrhoids  and  sinus.     22-23. 

In  case  the  foregoing  medicinal  remedies  prove 
ineffective,  the  patient  should  be  duly  bled  for  the 
purpose  of  letting  out  the  vitiated  blood  from  the 
system,  and  after  sufficiently  recouping  his  strength 
(after  blood-betting)  his  body  should  be  anointed  with 
clarified  butter.  Copious  vomitings  should  be  induced 
with  the  help  of  strong  emetics  and  the  patient  should 
be  treated  subsequently  with  a  judicious  administration 
of  purgatives  (so  as  to  remove  the  aggravated  Doshas 
from  the  system).  The  aggravated  Doshas  of  the 
body,  not  being  fully  expelled  from  the  organism  of 
a  Kushtha-patient  by  means  of  the  preceding  emetic 
and  purgative  measures,  tend  to  extend  all  over  the 
organism  and  the  disease  in  consequence  thereof  is  sure 
to  lapse  into  one  of  an  incurable  type.  Hence  the 
aggravated  Doshas  should  be  fully  eliminated  from  the 
organism.     24-25. 

Emetics  should  be  administered  to  a  Kushtha-patient 
once  a  fortnight  and  Sramsana  (purgatives)  once  a 
month.  He  should  be  bled  twice  a  year  though  not 
profusely  and  medicated  snuffs  should  be  administered 
to  him  every  fourth  day.     26. 

Internal  application  of  Haritaki^  Trikatu  and  treacle 

(  prepared  from  the  juice  of  the  sugarcane )   mixed  with 

oil  would  lead  to  the  early  recovery  of  a  case  of  Kushtha. 


Chap.  IX.]  CHIKITSA  STHANAM.  357 

As  an  alternative,  he  should  use  a  lambative  medicinal 
compound  of  Amalaka,  Aksha^  Pippali  and  Vidanga 
mixed  with  honey  and  claiified  butter.  Or  he  should 
take  a  Pala  weight  of  Haridrd  with*  an  adequate  quantity 
of  cow's  urine  every  day  for  a  month  in  order  to  get 
free  from  Kushtha ;  or  the  same  quantity  of  the  fine 
powder  of  Pippali  or  of  Chitraka  should  be  given  '  to 
him  through  the  same  vehicle  and  for  the  same  period 
which  would  cure  him  of  Kushtha.  The  same  quantity 
of  the  fine  powder  of  Rasdnjana  should  be  given  through 
the  said  vehicle  and  in  the  same  manner  for  a  period 
of  one  month  and  the  same  should  also  be  repeatedly 
applied  externally.     27-28. 

The  bark  of  Arishta  (Nimba)  and  Sapta-pamiJ^dkshd^ 
Musta,  Das'a-muli,  Haridrd,  Ddj-u-haridrd,  Manjishthd, 
A/cs/Mj  Vdsaka,  Deva  ddru,  Pathyd^  ChiU-aka  Trikati^^ 
Amalaki  and  Vidanga  taken  in  equal  parts  and  pounded 
together  should  be  mixed  with  powdered  Vidanga^^x^- 
ing  as  much  as  the  total  weight  of  the  preceding  drugs  ; 
the  patient  should  be  made  to  take  a  Pala  weight  of 
this  pulverised  compound  every  day  (for  a  month),  or  he 
should  be  made  to  drink  (in  adequate  doses)  a  Drona 
measure  of  medicated  clarified  butter,  cooked  with  the 
powders  of  Triphald  and  Trikatu.  As  an  alternative, 
Aksha-pida  should  be  boiled  in  a  Drona  measure  of 
cow's*  urine.  Clarified  butter,  cooked  in  this  pre- 
paration may  be  used,  as  a  remedy  for  Kushtha. 
An  adequate  quantity  of  old  and  matured  clarified 
butter  should  be  boiled  with  Aragvadhd.^  Sapta-parna^ 
Patola,  Vrikshaka,  Naktamdla,  Nimba,  the  two  kinds 
of    Haridrd    and    Mushkaka,     This  medicated   Ghrita, 

*  Cow's  urine  and  water  in  equal  parts  should  be  taken  according  to 
some  commentators.  Dallana,  however,  recommends  cow's  urine  only  and 
no  water, 


358  THE  SUSHRUTA  SAMHITA.  [Chap.  IX' 

thus  prepared,  would  lead  to  the  destruction  of 
Kushtha*     29-30. 

Drugs  such  as  Rodhra,Nimba^  Padma-kdshtha^  Rakta- 
chandana,  Sapta-parni,  Aksha,  Vrikshaka  and  Vijaka 
should  be  administered  in  the  bath-]*  of  the  patient  in 
the  event  of  there  being  any  burning  sensation  ;  or  a 
potion  consisting  of  honey  and  pasted  Tri-bhandi 
(Trivrit)  should  be  given  to  him.  Old  and  matured 
Mudga,  boiled  in  the  decoctionj  of  Nimha  and  mixed 
with  oil,  should  be  given  to  the  patient  as  drink  where 
sloughing  would  be  detected  in  the  diseased  localities. 
A  decoction  of  Nimha  or  that  of  Arka,  Alarka  and 
Sapta-chchhada  should  be  given  him  if  there  be  any 
worms  in  the  diseased  locality.  The  affected  part  of 
the  body  should  be  plastered  over  with  the  roots  of  the 
As'va-mdra  and  Vidanga,  pasted  with  cow's  urine,  in  the 
event  of  its  being  eaten  away  by  the  worms.  Cow's  urine 
should  be  sprinkled  over  the  diseased  locality  and  all 
food  (of  the  patient)  should  be  given  with  the  powders 
of  Vidanga.     31-32. 

As  an  alternative,  the  affected  parts  should  be 
rubbed  with  the  oil  of  Karanja,  mustard,  S'igru^  or 
Kos'dmra,  or  with  an  oil  (any  one  of  the  preceding  oils) 
cooked  with  (a  decoction  of)  pungent,  bitter  and  heat- 
producing  substances.  Measures  laid  down  under  the 
head  of  Dushta-Vrana  (malignant  ulcer)  should  be 
resorted  to  in  a  case  where  the  aforesaid  remedies  would 
fail  to  produce  any  beneficial  effect.     33. 

*  Dallana  says  that  the  authorship  of  this  remedy  should  not  be  attri- 
buted toSus'ruta,  inasmuch  as  Jejjata  does  not  meniion  it  in  his  commentary. 

t  The  drugs  are  to  be  boiled  in  water  in  which  the  patient  should 
take  his  bath. 

X    The  decoction  should  be  prepared   in  the   manrer  of  **Shadanga» 

Halpa." 


Chap.  IX.]  CHIKITSA  STHANAM.  359 

Vajraka-Taila  :— The  roots  of  Sapta-pama, 
Karanja,  Arka,  Mdlati,  Karavira,  Snuhi,  S'irisha, 
Chitraka  and  Asphotd  as  well  as  of  Vis  ha  (aconite  root), 
Ldngala,  Vajrdkhya  (mica),  sulphate  of  iron,  Haritdla^ 
Manah-s'ild  Karanja-SQQds,  Trikatu,  Triphald,  the  two 
kinds  of  Haridrd,  white  mustard-seeds,  Vidanga  and 
Prapunndda  should  be  pasted  together  with  the  urine  of 
a  cow.  The  paste  thus  prepared  should  be  cooked  in 
an  adequate  quantity  of  oil.*  This  oil  known  as  the 
Vajraka-Taila,  used  as  uguents,  proves  remedial  to 
Kushtha  etc.,  sinus  and  malignant  ulcers  in  general.    34. 

IVIaha-Vajraka  Taila  :~The  drugs  and  sub- 
stances known  as  white  mustard-seeds  (Siddhdrthaka), 
the  two  kinds  of  Karanja^  the  two  kinds  of  Haridrdy 
Rasdnjana^Kutaja^  Prapunndda,  Sapta-parna^Mrigddani 
Ldkshdy  Sarja-rasa^  Arka,  Asphotd,  Aragvadha^  Snuhi, 
S'irisha,  Tuvara^  Kutaja^  Arushkara,  Vacha,  Kushtha^ 
Vidanga,  Manjishthd,  Ldngali,  Chitraka,  Mdlati,  Katu- 
tumbi,  Gandhdhvd,  Mulaka,  Saindhava^  Karavira,  Griha- 
dhunia^  Visha  (aconite),  Kampillaka^  Sindura  (mercuric 
oxide),  Tejohvd  and  sulphate  of  copper  should  be  taken 
in  equal  parts  and  made  into  a  paste.  This  paste 
(Kalka)  should  be  cooked  with  either  Karanja-o\\  or 
mustard-oilf,  both  of  which  have  great  curative  potency, 
with  double  the  quantity  of  cow's  urine.  It  may  also  be 
prepared  with  sesamum-oil,  but  in  this  case  four  times  as 
much  of  cow's  urine  should  be  taken.  As  an  anointment 
it  is  undoubtedly  efficacious  in  a  case  of  Kushtha  of 
whatsoever  type  as  well  as  in  cases  of  scrofula,  fistula-in- 
ano,  sinus  and  malignant  ulcers.  This  oil  is  known  by  the 

*  S'ivadasa,  the  commentator  on  chakradatta,  asserts,  on  the  authority 
of  Vagbhata,  that  the  oil  should  be  sesamum-oil  and  it  should  be  boiled 
with  cow's  urine. 

t  According  to  Gayaddsa  mustard-oil  should  be  used. 


358  THE  SUSHRUTA  SAMHITA.  [Chap.  IX- 

thus  prepared,  would  lead  to  the  destruction  of 
Kushtha*     29-30. 

Drugs  such  as  Rodhra.Nimba^  Padma-kdshtha^  Rakta- 
chandana,  Sapta-parni,  Aksha,  Vrikshaka  and  Vijaka 
should  be  administered  in  the  bathf  of  the  patient  in 
the  event  of  there  being  any  burning  sensation  ;  or  a 
potion  consisting  of  honey  and  pasted  Tri-hhandi 
(Trivrit)  should  be  given  to  him.  Old  and  matured 
Mudga,  boiled  in  the  decoction|  of  Nimha  and  mixed 
with  oil,  should  be  given  to  the  patient  as  drink  where 
sloughing  would  be  detected  in  the  diseased  localities. 
A  decoction  of  Nimha  or  that  of  Arka^  Alarka  and 
Sapta-chchhada  should  be  given  him  if  there  be  any 
worms  in  the  diseased  locality.  The  affected  part  of 
the  body  should  be  plastered  over  with  the  roots  of  the 
As'va-mdra  and  Vidanga,  pasted  with  cow's  urine,  in  the 
event  of  its  being  eaten  away  by  the  worms.  Cow's  urine 
should  be  sprinkled  over  the  diseased  locality  and  all 
food  (of  the  patient)  should  be  given  with  the  powders 
of  Vidanga.     Zi-l^. 

As  an  alternative,  the  affected  parts  should  be 
rubbed  with  the  oil  of  Karanja,  mustard,  S'igru^  or 
Kos'dmra,  or  with  an  oil  (any  one  of  the  preceding  oils) 
cooked  with  (a  decoction  of)  pungent,  bitter  and  heat- 
producing  substances.  Measures  laid  down  under  the 
head  of  Dushta-Vrana  (malignant  ulcer)  should  be 
resorted  to  in  a  case  where  the  aforesaid  remedies  would 
fail  to  produce  any  beneficial  effect.     33. 

*  Dallana  says  that  the  authorship  of  this  remedy  should  not  be  attri- 
buted toSus'ruta,  inasmuch  as  Jejjata  does  not  mention  it  in  his  commentary. 

t  The  drugs  are  to  be  boiled  in  water  in  which  the  patient  should 
take  his  bath. 

X  The  decoction  should  be  prepared  in  the  manner  of  *'Shadanga. 
Ualpa." 


Chap.  IX.]  CHIKITSA  STHANAM.  359 

Vajraka-TaJIa  :— The  roots  of  Sapta-pama, 
Karanja,  Arka,  Mdlati^  Karavira^  Snuhi,  S'irisha, 
Chitraka  and  Asphotd  as  well  as  of  Visha  (aconite  roc»t), 
Ldngala,  Vajrdkhya  (mica),  sulphate  of  iron,  Haritdla^ 
Manah-s'ild  Karanja-seQds^  Trikatu,  Triphald,  the  two 
kinds  of  Haridrd,  white  mustard-seeds,  Vidanga  and 
Prapunndda  should  be  pasted  together  with  the  urine  of 
a  cow.  The  paste  thus  prepared  should  be  cooked  in 
an  adequate  quantity  of  oil.*  This  oil  known  as  the 
Vajraka-Taila,  used  as  uguents,  proves  remedial  to 
Kushtha  etc.,  sinus  and  malignant  ulcers  in  general.    34. 

lYIaha-Vajraka  Taila  :— The  drugs  and  sub- 
stances known  as  white  mustard-seeds  (Siddhdrthaka), 
the  two  kinds  of  Karanja^  the  two  kinds  of  Haridrd^ 
Rasdnjana^Kutaja^  Prapunndda,  Sapta-parna^Mrigddani 
Ldkshd,  Sarja-rasa,  Arka,  Asphotd,  Aragvadha,  Sttuhi, 
S'irisha,  Tuvara,  Kutaja^  Arushkara,  Vacha,  Kushtha^ 
Vidanga,  Manjishthd,  Ldngali,  Chitraka,  Mdlati,  Katu- 
tumbi,  Gandhdhvd,  Mulaka,  Saindhava^  Karavira^  Griha' 
dhunMy  Visha  (aconite),  Kampillaka^  Sindura  (mercuric 
oxide),  Tejohvd  and  sulphate  of  copper  shuuld  be  taken 
in  equal  parts  and  made  into  a  paste.  This  paste 
(Kalka)  should  be  cooked  with  either  Karanja-oW  or 
mustard-oil-f,  both  of  which  have  great  curative  potency, 
with  double  the  quantity  of  cow's  urine.  It  may  also  be 
prepared  with  sesamum-oil,  but  in  this  case  four  times  as 
much  of  cow's  urine  should  be  taken.  As  an  anointment 
it  is  undoubtedly  efficacious  in  a  case  of  Kushtha  of 
whatsoever  type  as  well  as  in  cases  of  scrofula,  fistula-in- 
ano,  sinus  and  malignant  ulcers.  This  oil  is  known  by  the 

*  S'ivadasa,  ihe  commentator  on  chakradatla,  asserts,  on  the  authority 
of  Vagbhata,  that  the  oil  should  be  sesamum-oil  and  it  should  be  boiled 
with  cow's  urine. 

t  According  to  Gayaddsa  mustard-oil  should  be  used. 


CHAPTER  X. 

Now  we  shall  discourse  on  the  medical  treatment 
of  major  cutaneous  affections  (IVIahfif-Kushtha).*  i. 

Metrical  Text  :— An  intelligent  physician 
should  have  recourse  to  the  following  medicinal  com- 
pounds in  virulent  types  of  Kushtha,  urinary  com- 
plaints (Meha),  diseases  due  to  the  action  of  the  de- 
ranged and  aggravated  Kapha  and  general  cedima  of 
the  body  and  also  in  respect  of  inordinately  corpulent 
persons  wishing  to  reduce  their  obesity.     2. 

IVIantha-KalpaS  : -Pounded  barley-corn 
should  be  saturated  with  the  urine  of  a  cow  and  kept  in 
a  large  bamboo  basket  (Kilinj  i)  for  the  whole  night ;  and 
shou'd  then  bi  drieJ  in  the  sun  on  the  following  day. 
This  process  should  be  continued  for  seven  consecutive 
days.  At  the  close  of  this  period  it  should  be  fried  in  an 
earthen  vessel  vKapdla)  and  then  ground  to  fine  powder 
(Saktu).  The  powder,  thus  prepared  should  be  given 
every  morning  to  a  person  afflicted  with  Kushtha 
(leprosy),  or  any  urinary  complaint  (Prameha)  through 
the  medium  of  a  decoction  of  the  drugs  included 
within  the  S' alas drddz  group,  or  of  the  Kantakz  {thorny )  f 
trees,  and  mixed  with  a  pulverised  compound  of  Bhalld- 
taka,  Prapunndda,  Avalguja,  Arka,  Chitraka^  Vidanga 
and  Musta  weighing  a  fourth  part  of  the  S'aktu.  Barley- 
corn    should,   in    the  same   manner,     be   soaked    in   a 

*  Kushtha  which  affects  the  deeper  tissues  and  fundamental  principles 
of  the  body  is  called  Maha-Kushtba. 

Gayi  interprets  the  term  "  Maha-Kushlha  "  as  signifying  those  seven 
types  of  Kushtha  which  cannot  be  attributed  to  any  detectable  cause, 

t  Vadara,  Khadira,  Arimeda,  Snuhi,  etc. 


Chap.  X.]  CHlKlTSA  STHANaM.  3,^3 

decoction  of  the  drugs  constituting  the  S' dla-sdrddi  or 
\.\mq  Aragvadhddi  ^XQM'^?,,  or  barley-corn  should  be  given 
to  a  cow  to  eat  and  the  undigested  barley-corn  passed 
with  the  cow-dung  should  be  collected.  This  barley- 
corn should  then  be  fried  and  powdered  in  the  form  of 
Saktu.  This  powder  should  be  mixed  with  a  pul- 
verised compound  of  Bhalldtaka^  etc.,  mentioned  above, 
and  given  to  the  patient  through  the  medium  of  a 
decoction  of  any  one  of  the  Khadira^  Asana^  Nimba, 
Rdja-  Vriksha,  Rohitaka  and  Guduchi,  sweetened  with 
honey  and  sugar,  and  acidified  with  grapes,  or  the  ex- 
pressed juice  of  pomegranate  and  Amla-vetasa  and 
then  mixed  with  rock-salt.  This  is  the  method  of  pre- 
paring all   kinds   of  Manthas.     3. 

Articles  of  food  made  of  barley-corn  in  the  form 
of  Dhana,  Lunchaka,  Kulmdsha,  Apupa,  Purnakosa, 
Utkarika,*  Sashkulika,  Kundrif  and  Kondli,  etc.,  should 
be  given  as  diet.  Preparations  of  wheat  and  Venu-yava 
(seeds  of  bamboo)  after  the  manner  of  barley  prepara- 
tions should  also  be  recommended  as  a  proper 
food.     4-5. 

lYIedicated  AriShtas  :— Now  we  shall  describe 
the  mode  of  preparing  Arishtas  (applicable  in  cases 
of  Kushtha).  Six  Pala  weight  of  each  of  the  following 
drugs,  viz.,  Putika,  Chavya,  Chiiraka,  Deva-ddru^  Sdrivd^ 
Danti  diXid  Trikatti,  3.r\d  one  Kudava  weight  of  Vadara 
and  Triphald  should  be  powdered.  An  earthen  jar  or 
pitcher,  which  formerly  contained  clarified  butter,  should 
be   purified]:    and    plastered    inside    with   a    compound 

*  Gayadasa  reads  Chilra  (a  kind  of  soup)  before  "  Utkarika.' 

t  Dallana  does  not  read  *'Konali"  but  says  that  some  read  **Konalika' 

in  place  of  "Kunari"  both  of  which  are    synonyms.     We  have,   however, 

both  the  terms  in  our  text. 

X  The  jar  should  be  purified   or    disinfected   by    fumigation   with   the 

medicinal  drugs  such  as  Nimba-leaves,  Guggulu,  etc. 


364  TriE  SUSHRUtA  SAMHITA.  [Chap.  X. 

of  honey,  clarified  butter  and  powdered  Pippali.  Then 
the  pulverised  compound,  mentioned  above,  together 
with  seven  Kudava  measures  of  water*  half  a  Kudava 
measure  of  iron-powder,  and  half  a  Tuli  weight  of  treacle, 
should  be  poured  into  the  said  jar  which  should  then  be 
tightly  covered  with  a  lid  and  placed  under  a  heap  of 
barley  for  seven  days  (for  fermentation).  After  this 
period,  it  should  be  taken  out  and  the  patient  should  be 
made  to  take  some  of  it  (every  day)  according  to  his 
physical  capacity.  This  Arishta  (fermented  liquor)  cures 
Kushtha,  obesity,  urinary  complaints  (Meha),  jaundice 
and  cedima.  Arishtas  may  also  be  similarly  perpared 
from  the  drugs  included  in  the  S'dla-sdradi,  the  Nya- 
grodhddi  or  the  Aragvadhddi  group.     6. 

Medicated  AsavaS  :— Now  we  shall  describe 
the  mode  of  preparing  Asavas.  The  ashes  of  burnt 
Palds'a  should  be  dissolved  in  hot  water  and  duly  filtered. 
Three  parts  of  this  (alkaline)  water,  subsequently  cooled, 
and  two  parts  of  Phanita  (molasses)  should  be 
mix^ed  together  and  fermented  in  the  manner  of  pre- 
paring Arishtat-  Asavas  may  be  similarly  prepared 
with  the  alkali  made  of  the  ashes  of  sesamum  plants 
(described  in  connection  with  the  treatment  of  As'mari 
— Chapter.  VII),  or  with  the  drugs  constituting  the  S'dla- 
sdrddiy  the  Nyagrodhddi,  or  the  Aragvadhddi  groups,  or 
with  cow's  urine  as  in  the  preceeding  manner.     7- 

Medicated  Suras  :— Now  we  shall  describe 
the  process  of  preparing  Surds  (wines).  A  decoction 
should  be  duly  made  of  S'ims'pd  and  Khadira  woods 
with  JJttamdrmi^  Brdhmi  and  Kos'dtaki  boiled  together 

*  Jejjata  recommends  twenty-eight  Pala  weight  of  water,  but  Gaya^ 
dasa  does  not  support  this. 

t  Powders  of  Putika,  Chiiraka,  etc.,  mentioned  in  connection  wiih  the 
preparation  of  Arishtas  should  be  likewise  added  to  it, — Dallana. 


Chap.  X.]  CHIKITSA  STHANAM.  365 

in  water*.  Then  Surd-kin va  (the  dru^  which  is  used  to 
cause  the  fermentation  in  the  manufacture  of  spirits) 
should  be  mixed  with  the  above  decoction  and  the 
compound  distilled  in  the  usual  officinial  method.  The 
liquor  thus  prepared  is  called  Sara'.  Suras  may  be 
similarly  prepared,  from  the  drugs  of  the  S' dla-sdrddU 
the  Aragvadhadi,   or  the   Nyngrodhddi  groups.     8. 

lYIedicated  Avalehas  (lambatives)  —Now 
we  shall  describe  (the  method  of  preparing)  medicated 
Avalehas  (lambatives).  A  decoction  should  be  prepared 
with  the  Sara  (essential  parts^  oi Khadira,  Asana,  Nimba, 
Rdfavriksha  and  S'dla. -f  Fine  powders  of  the  same 
dru^s  should  be  mixed  with  the  above  (decoction)  and 
boiled  again.  The  compound  should  be  removed  from 
the  fire  neither  thick  nor  thin.  The  patient  should 
be  made  to  lick  a  handful  I  of  the  compound  mixed 
with  honey  and  be  made  to  abstain  from  taking  any  meal 
in  the  morning.  Similar  preparations  may  be  made 
(Avaleha)  from  the  drugs  of  the  S'dla-sdrddi,  the  Arag- 
vadhddi,   or   the  Nyngrodhddi  groups.     9. 

Medicinal  Churnas:-Now  we  shall  de- 
scribe the  process  of  preparing  pulverised  compounds. 
A  Prashtha  measure  of  the  powdered  Sara  of  the 
trees   belonging   to  the   S'dla-sdrddi  group  should    be 


*  One  part  of  S'irns'apa',  one  of  Khadira  and  a  third  of  Uttamarani, 
Btahnii  and  Kos'aiaki  should  be  taken.  Tula  weight  of  the  drugs  and 
four  Drona  measures  of  water  should  be  boiled  and  reduced  to  one  Drona. 
— Dallana, 

t  Gayalasa  does  not  read  *'S'ala"  in  the  list. 

X  Though  the  word  "Panitala"  means  a  "Karsha"  i.e.y  two  Tol£s,  yet 
as  there  is  the  word  "Purnam"  inserted  after  it,  so  a  handful  should  be 
understood  here  by  this  term.— Dallana.  It  should  be  observed, 
however,  that  the  difference  in  the  two  interpretations  is  uhimaiely 
immaterial. —Ed. 


366  THE  SUSHRUTA  SAMHITA.  [Chap.  X. 

many  times  (i.  e,,  seven  days)  saturated  with  the  decoc- 
tion of  the  drugs  of  the  Arogvadhddi  group  (and  dried). 
Then  the  prepared  compound  should  be   taken  with   the 

-  vehicle  of  the  decoction  of  the  drugs  of  the  said  S'dla- 
sdrddi  group.  A  pulverised  compound  {Churna)  may  be 
as  well  prepared  in  the  above  manner  from  the  fruits 
of  the  Nyagrodddhi  group  or  from  the  flowers  of  the 
A ragvadhddi  group,  i  o . 
P~~^IYIeClicinaI  Ayaskriti  :  — Nowwe  shall  de- 
scribe the  process  of  preparing  an  Ayaskriti  (iron  com- 
pound). Thin  leaves  of  steel  should  be  plastered  with  the 
(five  officinal  kinds  of)  salts  and  heated  in  fire  a  of  dried 
cow-dung.  When  red-hot,  they  should  be  immersed  in  a 
decoction  of  Triphald  and  the  drugs  of  the  S' dla-sdrddi 
group.  The  above  process  should  be  repeated  sixteen 
times  in  succession  after  which  they  should  be  heated  and 
burnt  in  a  fire  of  Khadira  wood.  When  cooled  down, 
the  iron  foils  should  be  pounded  into  fine  powder  and 
passed  through  a  piece  of  thick  linen.  The  patient  should 
be  made  to  take  this  powder  with  honey  and  clarified 
butter  in  an  adequate  dose  suiting  his    capacity.     Af;er 

.  the  digestion  of  the  medicine,  he  should  take  such  a  meal 
as  is  not  hostile  to  hisparticular  disease  and  is  devoid 
of  salt  and  acid  articles.  The  use  of  a  Tula  measure 
of  this  medicinal  iron  preparation  in  the  above  manner 
leads  to  the  recovery  of  Kushtha,  Meha  (urinary  com- 
plaints), obesity,  oedima,  jaundice,  insanity  and  epilepsy 
and  makes  the  patient  live  for  one  hundred  years.  The 
use  of  each  additional  Tuld  weight  of  the  preparation 
adds  a  century  to  the  duration  of  the  user's  life. 
This  is  the  mode  of  medically  preparing  all  kinds  of 
Loha  (zinc,  copper,  lead  and  gold).    11-12. 

Aushadha  Ayaskriti :— A    ball    of    iron 

(weighing   fifty   Palas)   heated   and   made   red-hot  in  a 


Chap.  X.]  CHIKITSA  STHANAM.  367 

fire  of  Khadira  wood  should  be  cooled  by  immersing  it 
in  a  cauldran  (Droni),  made  of  (green)  Palds'a  wood 
and  containing  (five-hundred  Palas  of)  Svarasa  (expressed 
juice*yof  Trivit,  S'y^ma,  Agnimantha,  Samkhini,  Kevuka, 
Lodhra,Triphala,  Palas'a  and  Sims'apA.  The  iron  mass 
should  be  thus  heated  and  cooled  twenty  one  times 
in  succession  ;  finally  the  iron  ball  should  be  immersed 
and  boiled  in  the  expressed  juice  of  the  foregoing  drugs 
over  a  fire  of  cow-dungs.  It  should  be  removed  from 
the  fire  when  only  a  quarter  part  of  the  liquid  would 
remain.  It  should  now  be  filtered  and  the  mass  of 
iron  should  be  again  heated  in  the  fire  mixed  with  the 
same  liquid  and  boiled  again ;  when  the  cooking  is 
nearly  complete,  (it  should  be  removed  from  the  fire 
and)  a  pulverised  compound  of  the  drugs  included  in  the 
Pippalyddigvow^  together  with  honey  and  clarified  butter 
each  weighing  double  the  quantity  of  the  iron  mass  or 
ball  should  be  mixed  with  the  same.  When  cooled  down, 
this  preparation  should  be  preserved  in  a  well-sealed 
iron-pitcher.  The  medicine,  thus  prepared,  should  be 
given  to  the  patient  according  to  his  capacity  but  not 
less  than  a  Sukti  (.half  a  Pala)  or  a  Prakuncha  measure 
(one  Pala).  After  the  digestion  of  this  medicine,  a  diet 
should  be  given  to  the  patient  determined  by  the  nature 
of  his  disease.  This  is  called  the  Aushadha  Ayaskriti 
and  it  cures  even  the  incurable  types  of  Kushtha  and 
urinary  complaints  (Meha\  reduces  obesity,  impairs 
oedima  and  improves  the  impaired    digestive    functions. 

*  Old  and  experienced  physicians  explain  ^'Svaraswu"  to  be  the 
decoction  as  well.  Gaya<  asa  says  that  a  decoction  of  one  Drona  weight 
of  the  drugs,  boiled  in  four  Drona  weight  of  water  and  reduced  to  its 
quarter  part  should  be  taken.  Dallana  says  that  if  the  expressed  juice  of 
the  drugs  be  not  available,  then  a  cold  infusion  of  one  Adhaka  weight  of 
the  powdered  drugs  should  be  taken, 


368  THE  SUSHRUTA   SAMHITA.  [Chap.  X. 

It  is  specially  efficacious  in  cases  of  phthisis 
(Rdja-Yakshmd).  A  proper  and  regular  use  of  this 
remedy  increases  the  duration  of  life  to  a  hundred 
years.     13. 

IVIahaushaclha-Ayaskriti  :— A  decoction 

of  the  drugs  of  the  S'dla-sdrddi  group  should  be  poured 
in  a  Droni  (vessel)  made  of  Palds'a  wood.  Sheets  of 
iron  should  be  made  red-hot  and  cooled  down 
(twenty  one  times)  by  immersing  them  into  the  said 
decoction  of  the  drugs  of  the  .5  dia-sdrddi  group.  The 
interior  part  of  an  earthen  pitcher  should  be  disinfected 
(with' fumigation).  Then  the  iron  foils  and  the  powder 
of  the  drugs  of  the  Pippalyddi  group  together  with 
treacle  and  honey  should  be  added  and  preserved 
in  the  earthen  pitcher  with  its  mouth  well-covered 
with  a  lid  for  a  period  of  one  month  (in  winter)  or  a 
fortnight  (in  summer).  This  preparation  is  called  the 
Mahaushadha-Ayaskriti  and  an  adequate  quantity  of 
it  should  be  given  to  the  patient  after  the  lapse  of  the 
said  period.  Similar  preparations  of  (iron)  may  be 
made  with  a  decoction  of  the  drugs  of  the  Nyagro- 
dhddi  or  Arevatddi  (Aragvadhddi)  group.     14. 

— ^Thc    Khadira  Vidhana  :— Now  we   shall 

describe  the  Khadira  preparations.  The  earth  around 
the  central  root  of  a  middle-aged  Khadira  tree,  grown 
in  a  commendable  soil  and  not  worm-eaten,  should 
be  dug  out  and  the  central  and  principal  root  of  the 
tree  should  be  cut  open.  An  iron  pitcher  should  be 
placed  under  the  tree  so  that  the  secreted  juice  may 
collect  into  it  through  the  main  root.  The  outer  surface 
of  the  tree  should  be  completely  plastered  with  a 
paste  of  clay  and  cow-dung  (mixed  together).  It  should 
then  be  treated  with  a  fire  fed  with  faggots  mixed 
with   cow-dung    so   that    the     glutinous     secretions    of 


Chap.  X.]  CHIKITSA   STHANAM.  369 

the  Khadira  tree  would  naturally  settle  down  into  the 
pitcher  (through  the  principal  root).  When  the  pitcher 
is  filled  up,  the  juice  should  be  collected  and 
filtered  and  then  kept  in  another  vessel  with  its  lid 
carefully  closed  and  sealed.  The  extract  so  pre- 
served should  be  taken  in  proper  doses  with  honey,  clari- 
fied butter  and  the  expressed  juice  of  Amalaka.  The 
patient  should  be  made  to  take  such  diet  and  observe 
such  regimen  of  conduct,  as  has  been  prescribed  in 
connection  with  the  use  of  Bhallaitaka  compounds,  after 
the  digestion  of  the  medicine.  A  Prastha  measure  of 
this  remedy  gradually  taken  by  a  man  enables  him  to 
live  a  hundred  summers.      15. 

Khadira-Sara-Kalpa  :— A  decoction  made 

by  boiling  a  Tula  weight  of  the  essential  part  (Sdra)of  the 
Khadira  tree  with  a  Drona  measure  of  water  and  boiled 
down  to  a  sixteenth  part  of  its  original  quantity  should 
be  kept  in  a  vessel  with  its  mouth  tightly  closed. 
An  adequate  quantity  of  this  decoction  should  be  taken 
every  day  with  honey,  clarified  butter  and  the  expressed 
juice  of  Amalaka.  The  present  method  should  be 
adopted  with  the  extract  from  the  essential  parts  (Sdra) 
of  all  other  medicinal  trees.     16. 

Every  morning  the  patient  should  be  made  to  take 
an  adequate  dose  of  the  powders  of  Khadira-satra, 
or  its  decoction,  until  a  Tula  weight  is  consumed,  or 
he  should  be  made  to  take  a  potion  of  the  clarified 
butter  churned  from  the  milk  of  a  ewe  and  cooked  in 
a  decoction  of  Khadira-sara.  As  an  alternative 
the  expressed  juice  or  a  decoction  of  Amrita-valH,  or 
clarified  butter  cooked  with  that  juice  or  decoction, 
should  be  taken  every  morning.  The  patient  should 
every  afternoon  take  a  meal  of  boiled  rice  with  clari- 
fied butter  and  Amalaka-^ow"^.     A  constant    use  of  this 

4; 


370 


THE  SUSHRUTA  SAMHITA.  [Chap.  X. 


remedy  and  a  conformity  to  the  foregoing  diet  for  a 
month  would  lead  to  a  radical  cure  of  any  type  of 
Kushtha.     17. 

Oils  pressed  out  of  black  sesamum  and  Bhalldtaka, 
clarified  butter,  the  expressed  juice  of  Amalaka  and 
the  decoction  of  the  drugs  of  the  S'dla-sdrddi  group, 
each  weighing  a  Drona  measure,  and  a  Pala  weight 
of  each  of  the  following  drugs,  viz.,  Triphald^  Trikatu, 
the  pith  or  marrow  of  Parusha  fruit,  Vidanga  seed, 
Chitraka,  Arka,  Avalguja,  Haridrdy  Ddru-haridrd^ 
Trivrit,  Danti^  Indra-yava,  Yashti-madhu,  Ativishd, 
Rasdnjana  and  Priyangu,  should  be  boiled  together 
in  the  manner  of  cooking  medicated  oil,  etc.  (Sneha- 
pdka  Vidh^na).  When  well  cooked,  this  medicated  com- 
pound should  be  strained  (through  a  piece  of  clean  linen) 
and  carefully  preserved  (in  an  earthen  pitcher  with  its 
mouth  well  closed  with  a  lid).  The  system  of  the  patient 
should  be  well  cleansed  (with  appropriate  emetics 
and  purgatives)  and  a  Pala  weight  of  this  preparation, 
mixed  with  honey,  should  be  given  to  him  every 
morning.  After  the  digestion  of  this  medicine,  he 
should  be  made  to  take  a  light  meal  of  rice  well  cooked 
with  a  decoction  of  the  Khadira-wood  and  mixed  with 
clarified  butter,  and  the  soup  (Yusha)  of  Amalaka  or 
Mudga  unseasoned  with  salt.  A  Drona  measure  (of  this 
compound),  gradually  taken  in  the  aforesaid  manner  by 
a  patient  taking  a  (light)  decoction*  of  Khadira  (instead 
of  water),  would  ensure  a  speedy  recovery  from  all 
types  of  Kushtha  and  enable  the  patient  to  witness  a 
hundred  summers  (on  earth)  in  the  full  enjoyment  of 
sound  health  and   intellect.     18. 

*    The  decoction  of  Khadira-wood  for  drink  should   be  prepared  afteir 
the  manner  of  Shadanga-paniya  preparation.— Ed. 


Chap.  X.]  CHIKITSA  STHANAM.  37I 

Memorable  Verse  :— An  intelligent  physi- 
cian may  prepare  a  thousand  varieties  of  medicated 
remedies,  such  as  Surds,  Asavas,  Arishtas,  Lehas 
(lambatives),  powders  and  Ayaskritis  (metal-prepara- 
tions) with  the  aforesaid  drugs  and  in  the  manner 
described  above.     19. 

Thus  ends  the   tenth   Chapter   of  Chikitsita    Sthanam   in  the  Sus'ruta 
Samhitd  which  deals  with  the  medical  treatment  of  Maha-Kushtha. 


CHAPTER  XL 

Now  we  shall  discourse  on  the  medical  treatment  of 
the  diseases  of  the  urinary  tracts  (Prameha).      i. 

This  disease  may  be  ascribed  to  two  causes,  such 
as  the  congenital  (Sahaja)  and  that  attributable  to 
the  use  of  injudicious  diet.  The  first  type  (Sahaja) 
is  due  to  a  defect  in  the  seeds  of  one's  parents  and 
the  second  is  originated  from  the  use  of  unwhole- 
some food.  The  symptoms,  which  mark  the  first 
of  these  two  types,  are  emaciation  and  a  dryness 
(of  the  body),  diminished  capacity  of  eating,  too 
much  thirst  and  restlessness;  while  the  symptoms,  which 
usually  attend  the  latter  type  of  the  disease,  are  obesity, 
voracity,  gloss  of  the  body,  increased  soporific  tendency 
and  inclination  for  lounging  in  bed  or  on  cushions.  A 
case  of  emaciation,  etc.,  (viz.,  the  first  kind  of  Prameha) 
should  be  remedied  with  nutritious  food  and  drink,  etc., 
whereas  Apatarpana,  etc.,  (fasting,  physical  exercise, 
depletory  measures  etc.),  should  be  adopted  in  cases  of 
obesity  viz.,  the  second  kind  of  (Prameha).     2. 

Forbidden  Articles  of  Food  &  Drink : 

— All  patients  suffering  from  Prameha  should  forego 
the  use  of  (the  different  species  of  wine  and  fermented 
liquor  known  as)  Sauviraka,  Tushodaka,  Sukta,  Maireya, 
Surd,  and  Asava,  water,  oil,  clarified  butter,  milk,  any 
modification  of  the  expressed  juice  of  sugarcane,  cakes, 
milk-curd,  acid,  Pdnaka*  the  flesh  of  domestic  and 
aquatic  animals  and  of  those  which  frequent  swamps 
or  marshy  places      3. 

*  Made  of  sugar,  lemon-juice,  or  fermented  rice-gruel  boiled  together. 


Chap.  XL]  CHIKITSA  STHANAM.  373 

Articles  of  diet:— The  use  of  sufficiently  old 
and  matured,  S'dli  and  Shashtika  rice,  barley,  wheats 
Kodrava,  Udddlaka,  with  the  different  preparations  of 
Chanaka,  Adhaki,  Kulattha  or  Mtidga  pulse  is  recom- 
mended ;  or  the  meal  should  be  taken  with  the  S'dkas 
(potherbs)  of  bitter  or  astringent  taste  cooked  with  the 
oils  of  Nikmnbha,  Ingudi,  mustard  or  linseed  oil  ;  or 
with  the  soup  of  the  lean  flesh  of  Jdngala  animals 
which  are  possessed  of  anti-diuretic  properties  cooked 
without  any  clarified  butter  and  unseasoned  with  any 
acid  juice.     4. 

Preliminary  Treatment  :— -The   patient 

should  be  first  anointed  with  any  of  the  oils  (of  Nikum- 
bha,  Ingudi,  Sarshapa,  Atasi,  etc.);  or  with  the  medi- 
cated clarified  butter*  cooked  with  the  drugs  of  the 
Priyangvddi  group  and  should  also  be  treated  with  strong 
emetics  and  purgatives-f*.  After  the  application  of  pur- 
gatives, an  Asthapana  measure  with  a  decoction  of  the 
drugs  of  the  Surasddi  group,  mixed  with  honey  and  Sain- 
dhava  salt  and  with  the  powders  of  S'jinthi,  Bhadraddru 
and  Musta  by  way  of  an  after-throw,  should  be  resorted 
to.  (On  the  eighth  day)  in  a  case  attended  with  a  burn- 
ing sensation,  a  decoction  of  the  Nyagrodhddi  group 
without  {i.e ,  mixed  with  a  little  quantity  of)  Sneha  (oil 
or  clarified  butter)  should  be  used  (in  the  manner  of 
an  Asthapana). 

The  five  Medicinal  remedies  :— After 

cleansing  the  system,  the  expressed  juicej  of 
Amalaka  mixed  withZ/rtir^'^r^' (powder)  and  honey  should 

*  The  palient  should  be  anointed  with  the  medicated  clarified  butter 
in  a  case  of  Pittaja-meha. 

t  Emetics  in  cases  of  Kaphaja-meha  and  purgatives  in  those  of 
Pittaja-melia,  should  be  applied. 

X  This  is  also  found  in  Charaka  and  has  been  quoted  by  Chakradatta 
in  his  compilation. 


374  THE  SUSHRUTA  SAMHITA.  [Chap.  XL 

be  administered.  As  an  alternative,  a  decoction*  of 
Triphald,  Vis'dld,  Deva-ddru  and  Musta  or  an  Aksha 
(two  Tola)  measure  of  the  Kalka  (powders^-f-  of  S'dla, 
Kampillaka  and  Mushkaka  i^both  of  them)  sweetened 
with  honey  and  the  expressed  juice  of  Amalaka  should 
be  taken  ;  or  powders]:  of  the  flowers  of  Kutaja .Kapittha^ 
Rohita^  Vibhitaka  and  Saptaparna  (should  be  taken 
with  honey,  Haridrd  and  the  expressed  juice  of  Amalaka), 
or  a  decoction  of  the  roots,  leaves,  barks,  flowers  and 
fruits  of  Nimba,  Aragvadha^  Saptaparna,  Murvd,  Kutajay 
Soma-vriksha,  P aids  a  should  be  given  to  the  patient. 
All  cases  of  Meha  are  often  found  to  yield  to  the  use  of 
any  of  these  five  medicinal  preparations.     5. 

Specific  Treatments  :— Now  we  shall  speci- 
fically describe  the  course  of  treatment  to  be  adopted 
in  each  particular  type  of  the  disease  (Prameha).  A 
decoction  of  Pdrijdta  should  be  given  in  a  case  of 
Udaka-meha ;  a  decoction  of  Vaijayanti  in  that  of 
Ikshu-meha ;  a  decoction  of  Nimba  in  a  case  of  Surai- 
meha ;  a  decoction  of  Chitraka  in  a  case  of  S'ikatai- 
meha;  a  decoction  of  Khadira  in  a  case  of  S'anair- 
meha;  a  decoction  of  Pdthd  and  Aguru  in  a 
case    of     Lavana-melia  ;    a    decoction     of   Haridrd 

*This  is  quoted  by  Chakradalta  but  he  reads  «' ^j^f^j  "  in  place 
of  "  ^ej^jj^"  and  does  not  mention  the  use  of  the  expressed  juice  of 
Amalaka.     The  practice,  however,  is  to    follow  the  recipe  of  Chakradatla. 

t  The  third  Yoga  of  the  text  is  also  quoted  by  Chakradatla  but  no 
addition  of  Haridra  powder  is  prescribed  there.  Chakradatla  is  more 
generally  followed  in  the  case. 

X  The  fourth  Yoga  of  the  text  is  found  also  in  Charaka  although  wiih 
some  variation.  Charaka  adds  the  flowers  of  Kampilla  and  S'ala  in  the 
list,  but  does  rot  recommend  the  use  of  Haridra  powder  nor  of  the 
expressed  juice  of  Amalaki  as  the  medium  of  taking  the  medicine. 
Charaka,  however,  is  quoted  verbatim  by  Chakradalta  and  is  followed 
in  practical  use, 


Chap.  XI.]  CHIKITSA  STHANAM.  375 

and  Ddru'haridrd  in  a  case  of  Pishta-meha ; 
a  decoction  of  S'aptaparna  in  a  case  of  Sandra- 
meha  ;  a  decoction  o{  Du7'vdf  S'aivdla^  Plava,  Hatha- 
karanja  and  Kas'eruka,  or  that  of  Kakubha  and  red- 
sandal  wood  in  a  case  of  Sukra-meha  ;  and  a  decoction 
of  Triphald,  Aragvadha  and  Drdkshd  mixed  with  honey 
in  a  case  of  a  Phena-nieha.  All  decoctions,  to  be  em- 
ployed in  the  foregoing  ten  types  of  Kaphaja-meha, 
should  be  sweetened  with  honey  (slightly  sweetened  with 
honey — D.  R  ). 

Treatment   of  Pittaja  Prameha :    In 

the  Pittaja  types  of  the  disease,  a  decoction  of  the  drugs 
of  the  S'dla-sdrddi  group  or  that  of  As'vattha  should  be 
administered  in  a  case  of  Nila-meha  ;  similarly  a  de- 
coction of  Rdja-vriksha  should  be  given  in  a  case  of 
Haridrat-meha  ;  a  decoction  of  the  Nyagrodhddi  group, 
mixed  with  honey,  in  a  case  of  Amla-meha  ;  a  decoc- 
tion of  Triphld  in  a  case  of  Ksha'ra-meha  ;  a  decoc- 
tion of  Manjishthd  and  (red)  Chandana  in  a  case  of 
Manjishthai-meha ;  and  a  decoction  of  Guduchi,  seeds  of 
Tinduka,  Kds'marya  and  Kharjura^  mixed  with  honey, 
in  a  case  of  Sonita-meha*.     6. 

Palliative  IVIeaSUreS  :— Now  we  shall  de- 
scribe the  palliative  measures  to  be  adopted  even  in  cases 
of  incurable  types  of  the  disease.  A  Kalka  compound  of 
KushtJia^  Kutaja^Pdthd,  Hingu  diwd  Katu-rohini  should 
be  taken  with  a  decoction  of  Guduchi  and  Chitraka  in 
a  case  of  Sarpir-meha.  A  patient  afflicted  with  an 
attack  of  Vasa(-meha  should  be  made  to  drink  a  decoc- 
tion of  Agni-mantha  or  of  S'ims'apd.    Similarly  a  decoc- 

•  Honey  should  be  added  to  all  oi  these  decoctions  prescribed  in 
cases  Pittaja-meha. — Dallana. 

t  Honey  should  also  be  added  to  these  decoctions  prescribed  in 
cases  of  Valja  Meha — Dallana. 


376  THE  SUSHRUTA  SAMHITA.  [Chap.  XI. 

tion  o{  Khadira,  Kadara  and  Kramuka  should  be  given 
in  a  case  of  Kshaudra-meha  ;  a  decoction  of  Tinduka, 
Kapittha,  S'irisha,  Palds'a^  Pdthd^  Murvd^  and  Dus- 
parsd  (Duraiabh^)  mixed  with  honey  *  or  the  Kshara, 
(alkaline  water)  prepared  from  the  ashes  of  the  bones  of 
an  elephant,  horse,  hog,  ass  or  camel,  in  a  case  of 
Hasti-meha.  A  gruel  (Yav^gu  prepared  in  the  manner 
of  Shadanga-kalpa)  with  a  decoction  of  aquatic  bulbs 
and  sweetened  with  milk  and  the  juice  of  sugarcane 
should  be  prescribed  in  a  case  attended  with  a  burning 
sensation.     7. 

Medicinal    Arishtas,    Asavas,  Yava- 

gUSy  etc.  : — Likewise  Arishtas,  Ayaskritis,  lamba- 
tives  and  Asavas  should  be  prepared  (in  the  manner 
hereinbefore  described)  with  Priyangu,  A7tantd,  Yuthikd, 
Padmd  (Bhargi),  Trdyantikd,  Lohitikd,  Amhashthd,  bark 
of  pomegranate,  S' dla-parni,  (D.R. — Tala-parni),  Padma 
(lotus),  Tu7iga,  Kes'ura,  Dhdtaki,  Vakula,  S'alntali, 
S' ri'Ves htaka  and  Mocharasa,  should  be  administered 
to  the  patient.  As  an  alternative,  similar  preparations 
made  of  S'ringdtaka,  Gilodya^,  Mrindla,  Kas'eruka, 
Madhuka,  A'mra^  fainbu^  Asana,  Tinis'a,  Arjuna,  Kat- 
vanga^  Lodhra^  Bhalldtaka,  Charmi-vriksha,  Giri-karnikdy 
S'ita-s'iva,  Nichula^  Dddima,  Aja-karna,  Hari-vriksha, 
Rdjddana,Gopaghontd  diwd.  Vikamkata  should  be  prescrib- 
ed. Different  preparations  of  Yavagu,  etc.  should  be  given 
to  the  patient  as  diet.  A  gruel  (Yavagu)  cooked  with 
the  decoction  of  the  preceding  medcinal  drugs  or  (only 
these)  decoctions  should  be  given  to  the  patient  as  drinks. 
Potions  of  any  of  the  aforesaid  Asavas  thickened 
with  an  admixture  of  powdered  Pdthd,  Chitraka  and 
Haritaki  and  sweetened  with  a  liberal  quantity  of  honey 

*  Jejjata  interprets  it  as  grape-wine,  but    Gayadasa   does   not   support 
this  view. 


Chap.  XL]  CHIKITSA  STHANAM.  377 

should  be  prescribed  for  a  rich  or  royal  patient  of 
injudicious  conduct  and  refusing  to  take  medicines  ; 
or  he  should  be  made  to  drink  frequent  potions  of 
Mddhvika  liquors  (prepared  from  honey)  *  with  meat 
roasted  on  gridiron  over  a  charcoal  fire.  Food  and  drinks 
mixed  with  honey,  Kapittha  and  pepper  should  be 
prescribed  for  him.     8. 

The  powdered  dung  of  a  camel,  a  mule,  or  an  ass 
should  be  administered  to  him  in  food  ;  he  should  take 
his  meal  with  soups  saturated  with  a  compound  of 
asafoetida  and  Saindhava  salt  or  with  mustard  prepara- 
tions (Raga).  *  His  food  and  drink  should  be  fragrant 
and  well  flavoured  Iwith  ingredient  not  incompatible 
with  the  nature  of  the  disease.     9-10. 

The  practice  of  regular  physical  exercise,  wrestling, 
active  sports,  riding  on  a  horse  or  an  elephant,  long 
walks,  pedestrial  journeys,  practising  archery,  casting 
of  javelines,  etc.,  should  be  resorted  to  in  a  case  where 
the  disease  has  made  a  decided  advance.     11. 

A  poor  and  friendless  patient  should  live  on  alms, 
lead  a  life  of  perfect  continence  like  an  ascetic,  forego 
the  use  of  shoes  and  umbrella  and  walk  a  hundred 
Yojanasf  or  more  on  foot  without  staying  for  more  than 
one  night  at  a  single  village.  A  rich  man  (suffering 
from  Prameha)  should  live  on  S'ydmaka,  Kapittha, 
Tinduka  and  As'mantaka  and  live  among  the  deer. 
He  should  constantly  follow  the  tracks  of  cows  and  take 
their  dung  and  urine  (for  food  and  drink).  A  Brahman 
patient  should  live  on  the  grain,  spontaneously  fallen 
from   plants,    constantly    study  the    Vedas   and   draw 

*    Some    read    "liT#:"     i  e.    potherb    (  of   mustard  )    in     place    of 
t     A  Yojana  is  ecjual  to  eight  miles. 

48 


373  TttE  SUSHRUTA  SAMHITA.  CChap.  XI, 

chariots  occupied  by  Brahmanas.  *  A  patient  belong- 
ing to  the  lower  orders  of  society  i^Sudras,  etc.)  should  be 
made  to  sink  wells  (under  such  circumstances)  and  the 
strength  of  a  weak  or  emaciated  patient  should  be  pre- 
served vwith  nutritive  diets,  etc.).     12. 

IVIemorable  Verse  :— A  poor  patient,  carefully 
following  these  directions  of  his  medical  advisers 
without  the  least  demur  or  delay,  should  be  able  to  get 
rid  of  the  disease  (Prameha)  in  the  course  of  a  year  or 
even  in  less  than  that  time.     13. 

Thus  ends   the    eleventh    Chapter   of  the  Chikitsifa   Sthanam   in   the 
Sus'ruta  Samhita  which  deals  with  the  medical  treatment  of  Prameha, 


*  Some     explain    the    phrase    "^HT^q^^Urf"    to   mean   that     he 
should  retain  in  his  memory  (the  teachings  of)  the  Vedas.. —Dallana. 


CHAPTER  XIL 

Now  we  shall  discourse  on  the  medical  treatment  of 
the  abscesses  or  eruptions  which  mark  the  sequel  of  a 
case  of  Prameha   (Pramcha-PiClakgf).      i. 

The  nine  kinds  of  abscesses  (Pidakas),  such  as 
Sardvika,  etc.,  have  been  described  before.  Of  such 
abscesses  those,  appearing  in  a  strong  person  but 
small  in  size,  affecting  (only)  the  Tvak  (skin)  and  the 
flesh,  soft  to  the  touch,  slightly  painful,  easily  suppura- 
tive and  after  a  time  bursting,  are  curable.     2. 

Patients  suffering  from  Prameha  and  afflicted  with 
the  above  kinds  of  abscesses  (Pidakas)  should  be 
treated  (in  the  following  manner).  Measures,  such  as 
fastings  (Apatarpana),  etc.,  decoctions*  (of  Vata,  etc.) 
and  the  urine  of  a  she-goat,  should  be  employed  in  the 
incubative  stage  of  the  disease.  The  urine,  perspira- 
tion and  the  Sleshma  (sputum,  etc.),  soon  acquire  a 
sweetish  taste,  if  the  aforesaid  preliminary  measures 
are  not  resorted  to  and  if  the  patient  goes  on  using  sweet 
articles  of  food  in  utter  disregard  of  the  instructions, 
thus  developing  fully  the  specific  indications  of  Pra- 
meha. In  this  stage  the  system  of  the  patient  should 
be  cleansed  (Sams'odhana)  with  both  emetics  and 
purgatives.  If  the  disease  is  not  checked  (even  at 
this  stage)  with  the  aforesaid  measures  (emetics  and 
purgatives),  the  aggravated  Doshas  of  the  body  go  on 
increasing  in  intensity  and  tend  to  affect  or  vitiate  the 
flesh  and  the  blood  and  produce  an  inflamatory  swelling 
of  the  body,  or   bring    on   other   supervening   distresses 

*    Astringent  drugs  of  fig»tree(Vata-tree),  etc.— D.  R. 


38o  THE  SUSHRUTA  SAMHITA.  [Chap.  XII. 

in  their  train,  venesection  as  well  as  the  aforesaid 
remedies  and  measures  should  be  resorted  to  in  such 
cases.     3 . 

The  swelling  increases  in  size  attended  with  exces- 
sive pain  and  burning  sensation,  if  the  aforesaid  remedies 
be  not  employed  at  this  stage  of  the  disease.  Surgical 
operations  and  other  remedial  measures,  described  in 
connection  with  abscesses  or  inflammatory  swellings 
(Vrana)  in  general,  should  be  resorted  to  in  such  cases. 
If  these  be  not  done  (at  this  stage),  the  pus  eats  into 
the  deeper  tissues  of  the  locality,  creates  large  cavities 
in  its  inside,  and  is  accumulated  there  and  the  abscess 
(Vrana)  becomes  incurable.  *  Hence  a  case  of  Prameha 
should  be  remedied  at  its  very  outset.     4-6. 

DhsCnvantara-Ghrita :— Ten  Pala  weight  of 

each  of  these  drugs,  viz,^  Bhalldtaka^  Vilva,  Ambu,  roots 
of  Pippaliy  Ddakiryyd,  Prakiryyd'\,  Varshdbhu,  Punar- 
navdlt  Chitraka^  S'athi,  Snuhi,  Varunaka^  Pushkara^ 
Danti  and  Haritaki  and  one  Prastha  measure  of  each 
of  the  following,  viz.,  barley,  Kola  and  Kulattha  pulse 
should  be  boiled  with  a  Drona  measure  of  water.  The 
decoction  should  be  boiled  down  to  its  quarter  part, 
removed  from  the  fire,  and  strained.  It  should  then  be 
cooked  with  a  Prastha  measure  (four  seers)  of  clarified 
butter  with  half  a  Pala  weight  of  each  of  the  following 
drugs,  viz.f  Vachd,  Trivrit^  Kampilla^  Bhdrgi^  Nichula, 
S'unthiy  Gaja-Pippaliy    Vidanga  and  S'irisha   as  Kalka. 

*  On  the  failure  of  the  above  treatment  it  would  spontaneously  burst 
out  and  secrete  pus  and  force  its  way  inside,  which  would  lead  gradually 
to  widen  its  mouth  or  fissure,  and  help  its  running  into  an  incuvable 
stage. — Dallana. 

t    **Udakiry^  and  Prakiryd"  are  the  two  kinds  of  Karanja. 

X  "Varshabhu  and  Punarnava"  are  the  two  kinds  of  Punarnava 
(/.tf.,  red  and  white). 


Chap.   XII.]  CHIKITSA  STHANAM.  38I 

It  is  called  the  Dhatnvantara-Ghrita*  and  covers  within 
the  range  of  its  therapeutic  application  Meha  (urinary 
diseases),  swelling,  (S'otha),  Kushtha,  Gulma,  Ascites, 
haemorrhoids,  enlargement  of  the  spleen,  carbuncles 
(Pidaka)  and  abscesses.     7. 

Ordinary  purgatives  fail  to  produce  any  satisfactory 
effect  in  cases  of  Madhu-Meha  owing  to  the  excessive 
accumulation  and  pervasion  of  Medas  (fat)  in  the  or- 
ganism of  the  patient.  Hence  strong  Sodhana  (pur- 
gatives) should  be  employed  in  such  cases.  In  all  types 
of  Meha,  attended  with  PidakSL  (eruptions  or  abscesses) 
and  other  complications,  the  perspiration  and  expectora- 
tions, etc.  of  a  Prameha-patient  acquire  a  sweet  taste 
and  smell  like  that  of  honey.  Hence  they  are  techni- 
cally known  as  Madhu-Meha  (to  all  intents  and  pur- 
poses .  romentation  (of  any  kind)  is  forbidden  in  the 
case  of  a  patient  suffering  from  Madhu-Meha,  since  it 
might  lead  to  the  gradual  emaciation  of  his  frame  by 
drying  up  the  organic  fat  (Medas),  which  is  usually 
found  to  abound  in  his  organism.  The  aggravated  Doshas 
of  the  body  fail  to  make  an  upward  passage  in  the 
organism  of  a  Prameha-patient,  owing  to  the  weakness 
of  the  channels  of  chyle,  blood,  Kapha  and  Pitta  (as 
well  as  for  an  exhausted  condition  of  the  nerves  in  his 
body)  and  the  Doshas  are  thus  forced  to  course  in  and 
confine  themselves  into  the  lower  part  of  the  body  where 
their  incarceration  helps  the  easy  formation  of  Pidakais 
(abscesses),  etc.  Such  a  Pidaka  should  be  remedied  with 
the  measures  described  in  connection  with  Vranas,  as 
soon  as  the  process  of  suppuration  would  set  in;  whereas 

*  According  to  Dallana,  the  introduction  of  this  medicated  Ghrila 
into  the  text  is  an  interpolation.  Since  Jejjata  has  ftot  explained  it  in  his 
commentary,  Dallana  does  not  explain  it.  Chakradatta,  however, 
mentions  this  Ghrita  in  his  compilation,  though  with  some  additions  and 
alterations  under  the  treatment  of  Prameha.— Ed. 


382  THE  SUSHRUTA  SAMIllTA.  [C^hap.  Xtt. 

it  should  be  treated  as  a  swelling  in  its  unsuppurated 
stage.  Medicated  oils  should  be  likewise  employed 
for  the  purposes  of  healing  (Ropana),  etc.     8. 

A  decoction  of  the  drugs  of  the  Aragvadhddi  group 
should  be  used  for  the  purpose  of  raising  up  (Utsadana) 
the  cavity  of  the  incidental  ulcer  \  that  of  the  S'ala-sara'di 
group  should  be  used  for  sprinkling  purposes ;  that  of  the 
drugs  of  the  Pippalyddigrow^  should  be  given  as  food 
and  drinks.  A  pulverised  compound  o{  Pdthd,  Chitraka, 
S'drmgashtd,  Kshudra,  VriJiati,  S*drivd  Soma-valka^ 
Saptaparnay  Aragvadha  and  Kutaja  roots  mixed  with 
honey  should  be  internally  given  to  the  patient. 

S'ala-saradi  Avaleha  :— A  decoction  of  (one 

hundred  Pala  weight  of)  the  drugs  of  the  S'dla-sdrddi 
group  should  be  made  by  boiling  it  (in  sixteen  times  the 
weight  of  water)  down  to  a  quarter  part  (of  the  water)  and 
then  duly  filtered  (through  a  piece  of  linen).  It  should 
be  cooked  again  very  carefully,  so  that  it  may  not  be 
burnt;  powders  of  Amalakaf  Rodhra,  Priyamgu^  Danti, 
black-iron  and  copper  should  then  be  added  to  it  just 
before  the  completion  of  the  cooking,  so  that  it  may  be 
reduced  to  the  consistency  of  an  Avalcha  (lambative). 
It  should  then  be  removed  from  the  fire  and  kept  in  a 
closed  earthen  pitcher.  The  patient  should  take  an 
adequate  dose  of  this  medicine  as  it  is  a  sovereign  re- 
medy for  all  types  of  Prameha.     9. 

Navayasa-Churna  :•— Equal    parts    of   the 

powders    of  the   following   nine   drugs,    viz.,    Triphald, 
Chitraka^  Trikatu^  Vidanga  and  Musta^  and    nine   parts 

*  Chakradatta  reads  '*  S'ivd  "  in  place  of  "Amalaka"  and  does  not 
include  "  Priyamgu  "  in  the  list.  According  to  some  commentators  the 
total  weight  of  the  after-throw  (Prakshepa)  would  be  a  quarter  part  of  the 
total  weight  of  the  drugs  boiled  ;  whereas,  according  to  others,  the 
different  drugs  for  Prakshepa  would  weigh  one  Pala  each. 


Chap.  XII.]  CHIKITSA  STHANAM.  383 

of  powdered  black- iron*  should  be  mixed  together  and 
taken  in  adequate  doses  with  honey  and  clarified  butter. 
This  is  called  the  Navayasa  Churna,  which  proves 
curative  in  abdominal  obesity,  improves  the  impaired 
digestion  and  acts  as  a  prophylactic  against  haemor- 
rhoids, swelling,  jaundice,  Kushtha,  indigestion,  cough, 
asthma  and  Prameha,  etc.   10. 

LohariShta  :— A  decoction  of  the  drugs  of  the 
S'ald-sdrddi  group  should  be  made  by  boiling  it  down 
to  a  quarter  part  (of  the  original  quantity  of  water). 
Then  it  should  be  duly  filtered  j  when  cooled,  a  quantity 
[i.e.,  fifty  Pala  weight)  of  Makshika-honeyt  should  be 
added  to  it.  A  quantity  of  purified  treaclej  reduced  to 
the  consistency  of  Phanita  as  well  as  fine  powders  of 
the.  drugs  of  the  Pippalyddi  group  should  be  mixed  with 
it.     A    strong   and    well  cleansed  (earthen)  pitcher  satu- 

*  Charaka  and  Chakrapani  Datta  insert  this  medicine  among  the 
curatives  of  "  Pa'ndu-roga  ".  S'ivadasa  (the  commentator)  advises  to 
take  "  Manduia-iron"  instead  of  "  black-iron  ".  In  the  practical  field 
also  we  derive  great  and  good  efTects  in  cases  of  spleen  and  liver  diseases 
and  specially  in  cases  of  infantile  liver  and  heart  diseases. — Ed. 

t  Dallana  says  that  fifty  Pala  weight  of  each  of  the  two  substances — 
Madhva'sava  and  Pha'nita,  and  twenty-five  Pala  weight  of  each  of  the 
following  substances.,  viz.,  the  powders  of  the  drugs  of  the  Pippalyadi 
group  and  steel-foils,  should  be  taken  in  preparing  it.  But  Gayadasa 
explains  that  such  a  quanlity  of  old  and  matured  honey  should  be  mixed 
with  the  decoction  as  will  sweeten  it  ;  the  same  quantity  of  old  and 
matured  Phanita  treacle  should  be  taken  ;  the  powders  of  Pippalyadi 
group  should  be  added  to  it  till  it  gets  a  slight  astringent  (Katuka) 
taste. 

Some  commentators,  however,  hold  that  the  honey,  the  powders  of  the 
drugs  of  the  Pippalyadi  group  and  of  the  steel-foils  should  be  each  a 
quarter  part  of  the  decoction  in  weight. 

Dallana  explains  the  term  "Madhu"  as  the  A'sava  prepared  of 
honey.    Gayadasa,  however,  explains  it  simply  as  honey. 

t  The  Phanita  should  be  refined  by  dissolving  it  in  the  decoction  of 
the  drugs  of  the  S'ala-saradi  group  and  then  filtere  . — Dajlan^, 


384  THE  SUSHRUTA  SAMHITA.  [Chap.  XII. 

rated  with  clarified  butter  should  be  purified  (in  the 
usual  way)  and  its  interior  plastered  with  coating  of 
honey  and  powdered  Pippali  made  into  a  thin  paste. 
The  medicinal  compound  prepared  as  above  should  be 
kept  in  the  pitcher.  After  that,  thin  foils  of  steel  made 
red-hot  in  a  fire  of  Khadira  wood  should  be  immersed 
into  the  compound  prepared  before.  Then  the  pitcher 
with  the  steel-foils  immersed  into  its  contents  should  be 
kept  buried  in  a  heap  of  barley  for  three  or  four  months 
or  until  the  steel-foils  are  entirely  eaten  away  by  the 
medicine  and  the  characteristic  flavour  is  produced.  It 
should  be  used  in  proper  doses  every  morning  and  a 
suitable  diet  should  be  given  to  the  patient  after  its  use. 
It  reduces  fat,  improves  the  impaired  digestion  and 
proves  efficacious  in  cases  of  swellings,  internal  tumours, 
Kushtha,Meha, jaundice,  dropsy  of  the  spleen  (Plihodara), 
chronic  fever,  and  excessive  urination  (dribbling  of 
urine).  This  preparation  is  called  Loha^rishta*  and  it  is 
a  highly  efficacious  remedy.     11. 


*  The  recipe  of  Loharishta,  according  to  Vagbhata,  is  as  follows  : — 
The  drugs  of  the  Asanadi  group  (which  corresponds  with  Sus'ruta's 
S'ala-saradi  group),  each  weighing  twenty  Palas,  should  be  boiled  in  eight 
Dronas  of  water  down  to  a  quarter  part  of  its  weight.  Two  hundred  Pala 
weight  of  treacle  and  half  an  Adhaka  (four  seers)  of  honey  and  the  powders 
of  the  drugs  of  the  Vatsakadi  group  (which  corresponds  with  the  Pippa- 
lya'di  group  of  Sus'ruta),  each  weighing  one  Pala,  should  be  mixed 
with  the  abovei decoction  when  cooled.  A  (new  earthen)  pitcher  should 
be  plastered  inside  with  (an  adequate  quantity  of)  Pippali-powder  and 
honey,  the  outer  side  being  plastered  with  shellac.  The  above  prepara- 
tion should  now  be  poured  into  this  pitcher  which  should  be  kept  in  a 
heap  of  barley.  A  fire  should  be  kindled  with  Khadira  charcoal.  Thin 
iron-foils  should  be  alternately  heated  in  this  fire  and  immersed  in  the 
above  preparation  until  the  iron- foils  are  powdered.  Vagbhata  gives 
the  name  of  Ayaskriti  to  this  preparation. 

We,  however,  follow  Vagbhata  in  the  preparation  of  this  Arishta  with 
pood  results.. — Ed, 


Chap.  XII.]  CHIKITSA  STHANAM.  385 

Traits  of  cure  :  -The  cure  of  Prameha-patients 
should  be  understood  from  the  non-slimy  and  unturbid 
condition  of  the  urine  and  from  its  clear  transparent 
aspect  and  bitter  or  pungent  taste.     12. 

Thus  ends  the  twelfth  Chapter  of  the  Chikitsita  Sthanam  in  the  Sus'ruta 
Sambita  which  deals  with  the  medical  treatment  of  Prameha-Pidaka. 


49 


CHAPTER  XIII. 

Now   we   shall    discourse   on    the  medical  treatment 

of  Diabetes  (IVIadhu-IVIeha).    I. 

IVIetrical  Text  :— The  intelligent  physician 
should  adopt  the  following  course  of  treatment  in  the 
case  of  a  Madhu-Meha-patient  abandoned  as  incurable 
by  other  physicians.     2. 

^i  lajatu ,  its  origi  n  and  properties  :~ 

A  kind  of  gelatinous  substance  is  secreted  from  the  sides 
of  the  mountains  when  they  have  become  heated  by  the 
rays  of  the  sun  in  the  months  of  Jyaishtha  and  Ashadha. 
This  substance  is  what  is  known  as  the  Silajatu  and  it 
cures  all  distempers  of  the  body. 

The  presence  of  the  six  kinds  of  metal,  such  as  tin, 
lead,  copper,  silver,  gold  and  black-iron,  in  their  essen- 
tial form  in  the  substance  (Silajatu),  may  be 
detected  by  their  respective  smell  and  hence  it  is 
known  to  the  people  by  the  name  of  Shad-Yoni 
(lit. — having  six  different  origins).  The  taste  of 
this  shellac-coloured  substance  has  the  same  taste 
(Rasa)  and  potency  (Virya)  as  the  metal  to  whose 
essence  it  owes  its  origin.  It  should  be  understood  that 
as  tin,  lead  and  iron,  etc.,  are  progressively  more  and 
more  efficacious,  so  the  different  varieties  of  Sildjatu,  ori- 
ginated from  the  essence  of  tin,  lead,  iron,  etc.,  are  pro- 
gressively more  efficacious  in  their  application. 

All  kinds  of  Silajatu  have  a  bitter  and  pungent 
taste  with  an  astringent  after-taste  (Anu-rasa),  are 
laxative,  pungent  in  their  digestionary  reaction,  heat- 
making  in  their  potency  and  possessed  of  absorbing  and 
purifying  (Chhedana)  properties.     Of  these    what    looks 


Chap.  XIII.]  CHIKITSA  STHANAM.  387 

black  and  glossy,  is  heavy  and  devoid  of  sandy  particles, 
as  well  as  what  smells  like  the  urine  of  a  cow,  should 
be  considered  as  the  best.  This  best  kind  of  Sildjatu 
should  be  infused  with  the  decoction  of  the  drugs  of 
the  ^dla-sdrddi  group  after  the  manner  of  Bhavana 
saturation  (for  ten,  twenty  or  thirty  days).  Then  after 
cleansing  the  body  (by  the  application  of  emetics  and 
purgatives),  it  should  be  taken  every  morning  (by  the 
patient  in  adequate  doses),  well  pasted  with  Sdrodaka.* 
He  should  further  be  made  to  take  a  meal  of  boiled 
rice  mixed  with  the  soup  of  the  flesh  of  animals  of 
the  Jangala  group  after  the  medicine  had  been  fully 
digested.     3-4. 

A  Tuld  measure  of  this  hill-begotten  panacea 
(Sildjatu),  when  gradually  taken,  (in  adequade  doses) 
tends  to  improve  the  strength  and  complexion  of 
the  body,  cures  an  attack  of  Madhu-Meha  and 
enables  the  user  to  witness  a  hundred  summers  on 
earth,  free  from  disease  and  decay.  Each  Tula 
weight  of  this  medicine,  taken  successively,  adds  a 
century  to  the  duration  of  human  life,  while  ten  Tuld 
measures  extend  it  to  a  thousand  years.  The  regimen 
of  diet  and  conduct  during  the  period  of  its  use  should 
be  identical  with  that  described  in  connection  with  the 
use  of  the  Bhallaitaka  compounds.  Cases  of  Meha,  Kush- 
tha,  epilepsy  (Apasmara),  insanity,  elephantiasis,  poison- 
begotten  distempers,  phthisis,  aedema,  haemorrhoids, 
Gulma  (internal  tumours),  jaundice  and  chronic  fever, 
prove  readily  amenable  to  the  curative  efficacy  of 
Silajatu.     Indeed    there    is   no   such   bodily     distemper 

*  It  is  evident  from  the  reading  of  Chakradatta  that  "S^rodaka" 
means  a  decoction  of  the  drugs  of  the  ^sCla-S££rs£di  group.  But  Dallana 
explains  it  as  "Pancha-sarodaka"  which  is  quite  unintelligible.  In 
practice,  also,  Chakradatta  is  followed.— Ed, 


3^8  THE  SUSHRUTA  SAMHITA.         CChap.  XlII. 

which  does  not  yield  to  its  highly  curative  virtues.  It 
acts  as  a  potent  solvent  in  cases  of  long-standing  Sarkari 
(gravel)  in  the  bladder  as  well  as  of  stone.  Sildjatu 
should  be  treated  (soaked  and  dried)  with  appropriate 
medicinal  drugs  by  stirring  it  up  with  the  same.     5. 

The  MakShika  Kalpa:— The  metal  known 
as  Ms^kshika  (iron-pyrites),  which  grows  in  the  river 
Tapi  and  which  copes  with  the  divine  ambrosia  in  its 
highly  therapeutic  properties,  may  be  also  used  in  the 
same  way  and  under  the  same  sort  of  preparation. 
The  metal  is  divided  into  two  classes  according  to 
its  colour,  as  Svarna-Makshika  (gold-coloured)  and 
Rajata-Makshika  (silver-coloured).  Of  these  the  first  has 
a  sweet  taste  while  the  second  is  acid.  Both  of  them 
prove  efficacious  in  cases  of  decrepitude,  Kushtha,  Meha, 
jaundice  and  consumption.  A  person  using  SiMjatu 
and  Mdkshika  (in  the  manner  prescribed  above)  should 
refrain  from  taking  pigeon-flesh  and  Kulattha  pulse 
(during  his  life-time).     6. 

The  following  measures  should  be  adopted  by  an 
experienced  physician  in  the  case  of  a  patient  suffering 
from  (Meha  and)  Kushtha  and  who  has  a  firm  faith  in 
medicines  and  is  desirous  of  existence  (life)  and  in 
whose  case  the  curative  efficacy  of  Pancha-karma*  has 
been  baffled.    7. 

The Tu varaka  Kal pa :  —The  Tuvaraka  plants 
which  grow  on  the  shores  of  the  Western  Sea 
(Arabian  Sea)  are  constantly  tossed  about  by  the  winds 
raised  by  the  waves  of  the  sea.  The  pith  or  marrow 
of  the  seeds  (lit.— fruits)  of  these  plants  should  be  care- 

*  Some  take  the  term  in  its  ordinary  sense  to  mean  the  five  measures 
of  emetics,  purgatives,  etc.  ;  but  Dallana  would  explain  it  as  the  measures 
adopted  in  the  treatment  of  the  Kushtha  affecting  the  bcJne  which  is  the 
fifth  Dhatu  in  the  system. 


Chap.  Xni.]  CHIKITSA  STHANAM.  389 

fully  collected  in  the  rainy  season  while  they  ripen  and 
should  be  subsequenly  dried  and  pounded.  The  oil 
should  be  either  pressed  out  of  these  seeds  in  a  mill  in 
the  manner  of  preparing  sesamum  oil,  or  squeezed  out 
(of  a  press  bag)  like  that  used  in  the  case  of  Kusumhha 
flowers.  The  oil  should  be  boiled  over  a  fire  so  as  to 
have  its  inherent  watery  particles  completely  evaporated. 
Then  it  should  be  taken  down  from  the  fire  and  kept  in 
a  pitcher  and  then  buried  for  a  fortnight  in  a  heap  of 
well  dried  cowdung.  The  patient  (in  the  meantime) 
should  be  duly  anointed,  fomented  and  treated  with 
cleansing  remedies  \^i.e.,  emetics  and  purgatives).*  He 
should  wait  a  fortnight  (after  the  administration  of 
the  aforesaid  measures)  and  wait  for  a  period  of 
four  mealsf  (i.e.,  two  days)  more  ;  and  on  the  next 
morning  he  should  drink  a  portion  of  the  oil  in  ade- 
quate doses  (two  Tolds)  under  the  auspices  of  favourable 
astral  combinations  in  the  lighted  fortnight  of  the  month. 
He  should  be  made  to  recite,  at  the  time  of  his  taking 
the  fourth  dose,  a  Mantra  which  runs  as  follows  : — 
"Cleansest  and  purifiest,  O  Thou  potent  essence  of  seed- 
marrow,  all  the  essential  principles  of  (my)  vital  organism. 
The  deity  who  knows  no  decay  and  suffers  no  change  and 
who  weilds  a  discus,  a  mace  and  a  conch-shell  in  his 
arms,  commands  thee  on  that  behalf." 

The  Doshas  in  both  the  upper  and  the  lower  parts  of 
a  patient's  body   are    cleansed  with  the    help  of  this  oil 

*  The  Kapha  should  be  first  reduced  with  emetics  ;  and  after  a 
fortnight,  the  Pitta  with  purgatives.  A  fortnight  after  the  use  of  purgatives, 
a  potion  of  the  Tuvarka  oil  should  be  administered  inasmuch  as  it  is  a 
Sams'odhaka  (cleansing)  remedy 

t  On  the  sixteenth  day  after  the  administration  of  the  cleansing  mea- 
sures,  as  well  as  on  the  morning  of  the  seventeenth  day,  the  patient  should 
take  his  meals  as  usual.  On  the  evening  of  the  seventeenth  day  no  meal 
should  be  taken.     On  the  following  morning  the  oil  should  be  taken. 


390  THE  SUSHRUTA  SAMHITA.  [Chap.  XIII. 

(which  should  be  given  to  the  patient  in  the  morning) ; 
while  a  cold  gruel,  unseasoned*  with  salt  and  not  mixed 
with  any  emollient  substance  (oil  or  clarified  butter) 
should  be  given  to  him  in  the  afternoon.  The  use  of  this 
oil  should  be  repeated  in  the  same  manner  for  five  days 
in  succession,  and  the  patient  should  avoid  anger, 
etc.,  and  live  on  Mudga  soup  (Yusha)  and  boiled  rice  for 
a  fortnight.  A  five  days'  use  of  this  oil  would  ensure 
the  cure  of  every  types  of  Kushtha  (and  Madhu- 
meha).     8-9. 

The  foregoing  (Tuvaraka)  oil  should  be  boiled  and 
prepared  with  a  decoction  of  Khadira  weighing  three 
times  the  quantity  of  the  oil  and  taken  internally  with 
patience  for  a  month  for  the  same  purpose.  The  patient 
should  anoint  his  body  with  the  same  and  then  take  his 
meals  in  the  prescribed  form.  A  Kushtha-patient  (as 
well  as  a  Meha-patient)  suffering  from  hoarseness,  red- 
eyes and  with  worm-eaten  and  emaciated  limbs  should 
be  speedily  treated  with  this  oil  as  an  anointment  and 
a  drink.  Regular  potions  of  the  above  medicinal  (Tuva- 
raka) oil  taken  with  honey,  clarified  butter  and  a 
decoction  of  Khadira  and  a  diet  consisting  of  the  soups 
of  bird's  flesh  (during  its  course)  would  enable  the  user 
to  live  for  a  period  of  two  hundred  years.  A  use  of  this 
oil  as  errhines  (Nasya)  for  a  period  of  fifty  consecutive 
days  would  enable  the  user  to  witness  three  hundred 
years  on  earth,  in  the  full  enjoyment  of  bodily  vigour 
and  a  youthful  glow  of  complexion,  as  well  as  with  a 
very  powerful  retentive  memory. 

A  regular  use  (in  an  adequate  dose)  of  the  pith 
of  Tuvaraka  cleanses  the  system  of  the  patient 
and  is  a  most  potent  remedy  in  cases  of  Kushtha 
and  Meha.     10. 

*  A  little  quantily  of  sail  and  of  oil  or  clarified  butter  may  be  given. 


Chap.  XIII.]  CHIKITSA  STHANAM.  39I 

The  pith  (inner  pulp  of  the  seeds^  of  the  Tuvaraka 
burnt  in  a  closed  vessel  (Antar-dhuma)  should  be  mixed 
with  Saindhava-salt,  Anjano^  and  Tuvaraka  oil.  This 
prepared  compound,  used  as  a  coUyrium,  is  efficacious  in 
cases  of  eye-diseases,  such  as  night-blindness,  Arman, 
Nili,  Kdcha-roga  (dimness  of  sight)  and  Timira.     11. 

Thus  ends  the  thirteenth  Chapter  of  the  Chikitsita  Sthanam  in  the 
Sus'ruta  Samhita  which  deals  with  the  treatment  of  Madhu-Meha. 

*  Dallana  recommends  the  three  thing?,  viz.,  the  pith  of  the  Tuvaraka, 
the  Saindhava-salt  and  the  Rasanjana  to  be  mixed  and  burnt  together  in  a 
closed  vessel. 


CHAPTEE  XIV. 

Now  we  shall  discourse  on  the  medical  treatment  of 
dropsy   with   an    abnormal    condition   of  the  abdomen 

(Udara).    i. 

Of  the  eight  different  types  of  Udara,  described  be- 
fore, those  severally  known  as  the  Vaddha-guda  and  the 
Parisrdvi  should  be  understood  as  incurable,  the  rest  being 
equally  hard  to  cure.  Hence  the  medical  treatment  of  all 
cases  of  Udara  (abdominal  dropsy)  should  be  resorted  to 
without  holding  out  any  positive  hope  of  recovery.  The 
first  four  types  of  the  disease  (as  metioned  in  the  list  of 
enumeration),  may  prove  amenable  to  medicine  ;  but  the 
rest  would  require  Surgical  treatment.  All  the  types  of 
the  disease,  however,  would,  with  the  progress  of  time, 
require  a  surgical  operation,  or  (attaining  an  incurable 
stage)  they  may  have  to  be  abondned.     2. 

Diet  of  articles  forbidden  :— A  patient, 

afflicted  with  an  attack  of  Udara,  should  forego  the  use 
of  heavy  (indigestible),  or  emollient  fare,  of  all  kinds 
of  meats  and  of  those  that  produce  a  state  of  extreme 
dryness  in  the  system,  or  produce  a  slimy  secretion  from 
the  channels  (of  the  Doshas  and  the  vital  principles)  of 
the  body,  or  give  rise  to  a  sort  of  digestionary  acid 
reaction  (acid  transformation  in  the  stomach)  and  re- 
frain from  bathing  and  using  effusions.  Meals  consisting 
of  well  cooked  S'dli  rice,  barley,  wheat,  or  Nivdra  seeds 
should  be  the  daily  diet  of  such  a  patient.     3. 

Treatment  of  the  Vsitaja  type  :-ln  a 

case  of  Vdtaja  Udara,  the  body  of  the  patient  should  be 
anointed  with  clarified  butter  cooked  with  the  drugs  of 
t;he  Viddri'gandhddi  group,   while  the  one   cooked  with 


Chap.  XIV.]  CHIKITSA  STHANAM.  393 

Tilvaka  should  be  used  as  purgatives  (Anuloma),  A 
compound  made  of  a  copious  quantity  of  oil  of 
Chitrd  seeds,  mixed  with  a  decoction  of  the  drugs  of  the 
Viddri-gandhddi  group,  should  be  used  as  Asthapana 
and  Anuvasana  measures.  The  Sailvana  Upansiha 
(poultice)  should  be  applied  to  the  abdomen.  Milk 
cooked  with  the  drugs  of  the  Viddri-gandhddi  group, 
or  the  soup  of  the  flesh  of  Jdngala  animals  should  be 
given  to  the  patient  with  his  meal  and  the  affected 
region  should  be  frequently  fomented.     4. 

Treatment  of  the  Pittaja  Type  :—  In 

a  case  of  Pittaja  Udara,  the  patient  should  be  anointed 
with  clarified  butter  cooked  with  the  drugs  of  the 
Madhura  (Kdkoly^di)  group.  Similarly,  clarified  butter 
cooked  with  S'ydmd,  Jriphald  and  Trivrit  should  be 
used  as  purgatives  and  the  decoction  of  the  drugs  of  the 
Nyagrodhddi  group,  mixed  with  a  copious  quantity  of 
sugar,  honey  and  clarified  butter,  should  be  used  as 
Anuvasana  and  A'sthdpana  measures.  The  abdomen 
should  be  poulticed  with  Payasa  (porridge  prepared  with 
rice  and  milk)  and  the  diet  should  consist  of  boiled  rice 
and  milk,  cooked  with  the  drugs  of  the  Viddri-gandhddi 
group.     5. 

Treatment  of  the'Kaphaja  Type  :— In 

a  case  of  Kaphaja  Udara,  the  patient  should  be  anointed 
with  clarified  butter,  cooked  with  the  decoction  of  the 
drugs  of  the  Pippalyddi  group.  Likewise,  clarified 
butter,  cooked  with  the  milky  juice  of  Snuhi  plants, 
should  be  used  as  purgatives  ;  and  the  decoction  of  the 
drugs  of  the  Mushkakddi  group,  with  a  copious  quantity 
of  Trikatu^  cow's  urine,  Kshdra  (Yava-kshara)  and  oil, 
should  be  applied  as  Anuvasana  and  Asthapana 
measures.  A  poultice  (Upandha)  prepared  of  S'ana 
seeds,  Atasi  seeds,    DhdUiki  (flower),  mustard,   Mulaka 

50 


394  THE  SySHRUTA  SAMHITA.  [Cbap.  XIV. 

seeds  and  Kinva  should  be  applied  (hot)  to  the  ab- 
domen. The  diet  should  consist  of  (boiled  rice  well- 
mixed  with)  Kulattha  soup  (Yusha),  profusely  seasoned 
with  powdered  Trikatu,  or  of  Payasa  ;  and  the  abdomen 
should  be  frequently  fomented.     6. 

Treatment  of  Dushyodara  :— in  a  case 

of  Dushyodara,  the  patient  should  be  treated  without 
giving  any  hope  of  a  positive  cure.  Purgatives  with 
clarified  butter,  cooked  with  the  expressed  juice  of 
the  Saptald  and  S'amkhini,  should  be  first  administered 
(continuously)  for  a  fortnight  or  even  a  month ;  or  clari- 
fied butter,  cooked  with  the  milky  juice  of  the  Mahd- 
vriksha^  and  with  wine  and  cow's  urine,  should  be  simi- 
larly used  as  a  purgative.  A  Kalka  made  up  of  the  roots 
of  the  As'vanidraka,  Gunjd  and  Kdkddani  mixed  with 
wine  (Sura),  should  be  given  after  the  bowels  had  begun 
to  move  freely.  As  an  alternative,  a  Krishna- Sarpa  (black 
lance-hooded  cobra)  should  be  enraged  to  bite  a  sugarcane 
and  this  piece  of  sugarcane  should  be  given  to  the  patient 
to  chew  (and  suck) ;  or  the  fruits  of  creepers  (Valli-phala) 
should  be  used  (in  the  preceding  manner) ;  or  poisonous* 
roots  and  bulbs  should  be  prescribed,  whereby  the 
disease  may  be  cured  or  may  take  a  different  turn.     7. 

IVIemorable  Verse:— A  case  of  abdominal 

dropsy  (Udara)  of  whatsoever  type  should  be  presumed 
to  have  its  origin  in  an'  aggravation  of  the  bodily 
Vdyu  and  an  accumulation  of  faecal  matter  in  the 
bowels  ;  hence  frequent  use  of  Anulomana  (purgatives, 
etc.)  is  recommended  in  this  disease.     8, 

*  If  this  be  not  done,  the  patient  is  sure  to  die  j  but  it  is  not  certain 
whether  he  would  get  any  relief  from  this  treatment.  It  being,  however, 
possible  in  some  cases  to  save  the  life  of  a  patient  by  the  application 
of  this  medicine,  it  should  be  used,  as  the  last  resort  with  the  permission 
of  the  king.^Dallana. 


Chap.    XIV.]  CHIKITSA   STHANAM.  395 

General     Treatment :—  Now    we    shall 

describe  a  few  general  medicinal  compounds  (which  may 
be  used  with  advantage  in  cases  of  Udara).  They  are  as 
follows  ; — Castor  oil  with  milk  or  with  the  urine  of  a  cow 
should  be  taken  for  a  month  or  two.  No  water  should 
be  taken  during  the  period,  or  the  patient  should  forego 
the  use,  of  water  and  all  other  food,  but  drink  only  the 
urine  of  a  she-buffalo  and  (cow's)  milk  ;  *  or  he  should 
live  upon  the  milk  of  a  she-camel  alone,  foregoing  the 
use  of  rice  and  water  and  submit  himself  to  a  course  of 
Pippali  for  one  month  in  the  manner  described  before 
(under  the  treatment  of  Mahd-Vatavyddhi),-|*  or  take  the 
oil  of  the  Nikumbha  with  Saindhava-salt  and  powdered 
Ajamodd  dissolved  in  it.  The  said  oil  (of  Nikumbha), 
cooked  with  a  hundred  Pdtra  weight  of  the  expressed 
juice  of  A'rdraka  and  S'ringavera  (fresh  ginger),  should  be 
applied  in  the  event  of  there  being  any  Sula  (colic  pain), 
due  to  the  action  of  the  deranged  and  aggravated  Vdyu. 
Milk,  boiled  with  the  expressed  juice  of  S'ringavera 
(fresh  ginger),  should  be  taken.  A  paste-compound  of 
Chavya  and  S'ringavera,  or  a  paste-compound  of  Sarala^ 
Deva-ddru  and  Chitraka  (with  milk),  or  a  paste-com- 
pound of  Murangi,  S'dlaparni,  S'ydmd  and  Punarnavd 
(with  milk),  or  the  oil  of  Joytishka  seed,  mixed  with 
milk,  Svarjikd  and  Asafoetida,  should  be  administered 
to  the  patient.     9. 

He  should  take  Haritaki  with  treacle,  or  a  thousand 
Pippali  soaked  (twenty  one  times)  with  the  milky  juice 
of  the  Snuhi  plant  \ys\  the  manner  of  Bhavand  saturation), 
should  be  gradually  consumed.     Powdered    Pippali  and 

*  The  milk  here,  says  Dallana  on  the  authority  of  Jejjata,  should  be 
buffalo's  milk.  But,  according  to  Vagbhata  and  S'ivadasa,  the  commen- 
tator of  Chakradatta,  cow's  milk  should  be  used.— Ed. 

t  The  Pippalis  shohld  be  taken  with  milk  only  in  the  present  instance, 


396  THE  SUSHRUTA  SAMHITA.  [Chap.  XIV. 

Haritaki  should  be  soaked  with  the  milky  juice  of  the 
Snuhi  plant  (and  dried  in  the  sun).  Utkarika  should 
now  be  preapared  with  this  compound  and  given  to  the 
patient.     lo. 

The  Haritaki  Ghrita:--A  Prastha  mea- 
sure of  powdered  Haritaki  should  be  mixed  with  an 
Adhaka  measure  of  clarified  butter  and  heated  over  a  char- 
coal fire  by  stirring  it  up  quickly  with  a  ladle  ;  when  well 
mixed,  the  compound  should  be  poured  into  an  earthen 
pitcher,  which  should  be  kept  well  corked  and  buried 
in  a  heap  of  barley  for  a  fortnight.  The  pitcher  should 
then  be  taken  out  and  the  compound  should  be 
strained  and  cooked  again  with  an  adequate  *  quantity 
of  the  decoction  of  Haritaki,  Kdnjika  (fermented 
rice-gruel)  and  curd.  The  patient  should  use  this  medi- 
cine for  a  month  or  a  fortnight  in  proper  doses  and 
with  adequate  vehicles,     ii. 

The  MahaL-vriksha  Ghrita:— A  quantity 

of  the  milky  juice  (one  fourth  of  the  cow's  milk  in  quanti- 
ty) of  the  Mahd-vriksha  (Snuhi  plant),  should  be  boiled 
with  cow's  milk.  Then  it  should  be  removed  from  the  oven, 
cooled  down  and  churned  (with  a  churning  rod).  The 
butter  thus  prepared  and  cooked  again  with  the  milky 
exudations  of  the  Mahd-vriksha  (and  an  adequate 
quantity  of  water)  should  be  given  to  the  patient  for 
a  month  or  a  fortnight  in  adequate  doses  and  with 
proper  vehicles.     12. 

The  Chavy^di  Ghrita  :— Half  aKarsha  (one 
Tola)  measure  of  each  of  the  following  drugs,z'2>.,  Chavya, 
Chitraka^  Danti,  Ativishd,  Haridrd,  S'amkhiniy  Trivrit 
and  Trikatu,  together  with  an  eight  Karsha  measure  of 
the  inner  pulps  of  the  fruit  (seeds)  of  the    Rdja-vriksha, 

*  Each  of  the  three  things  (liquids)  should   be  four   times   as   much  ag 
the  clarified  butter. 


Chap.  XIV.]  CHIKITSA   STHANAM.  397 

two  Pala  weight  of  the  milky  juice  of  the  Mahd-vriksha^ 
eight  Pala  weight  of  cow's  milk  and  eight  Pala  weight  of 
cow's  urine,  shpuld  be  cooked*  with  a  Prastha  measure 
(four  seers)  of  clarified  butter.  The  medicated  Ghrita,  thus 
prepared,  should  be  given  in  convenient  doses  to  the 
patient  for  the  period  of  a  month  or  a  fortnight.     13. 

The  aforesaid  three  Ghritas  (Haritaki-Ghrita,  Mahd- 
vrlksha-Ghrita  and  Chavyddi-Ghrita)  and  the  Tilvaka- 
Ghrita  (mentioned  in  the  chapter  dealing  with  Vdta- 
vyddi)  should  be  employed,  whenever  purgatives  would 
be  necessary  in  cases  of  Udara,  internal  tumour  (Gulma), 
abscess,  AshthiU,  Anaha,  Kushtha,  insanity  and 
epilepsy.     14. 

Constant  use  of  (cow's)  urine  or  (any  kind  of)  Asava, 
Arishta  or  wine,  cooked  with  the  milky  exudation  of 
Mahd-vrikshd,  -j*  is  recommended.  A  decoction  of 
purgative  drugs,  thickened  with  an  admixture,  in 
copious  quantity,  of  powdered  S'unthi  and  Deva-ddru, 
may  be  used  with  advantage  in  this  desease. 

AnSlha  Varti:— APala  weight  of  the  emetic 
and  purgative  drugs  and  the  same  weight  of  the  fine 
powders  of  the  drugs  of  each  of  the  Vachddi^  Pippalyddi 
and  the  Haridrddi  group,  and  all  the  officinal  kinds  of 
salt  should  be  mixed  (with  four  or  eight  times  that  of)  the 
urine  (of  a  cow,  buffalo,  etc.).  Then  this  (^mixture)  com- 
pound should  be  boiled  and  cooked  over  a  gentle  fire  with 
a  Prastha  measure  of  the    milky  juice    of  Mahd-vriksha 

*  In  the  absence  of  any  mention  about  the  quantity  of  water  to  be 
added,  four  limes  as  much  of  water  should  be  added  for  the  completion  of 
the  preparation  according  to  the  general  maxim. — Ed. 

t  Dallana  explains  the  sentence  as  follows  : — 

Asavas,  Arishtas  and  Suras  should  be  prepared  with  urine  (instead  of 
the  liquid  i.e.,  water)  and  the  milky  exudation  of  Maha-vriksha  (as  ap 
after-throw),  and  should  be  constantly  used. 


398  THE  SUSHRUTA  SAMHITA.  [Chap.  XIV. 

by  constantly  stirring  it  with  a  ladle.  Precaution  should 
be  taken  so  that  the  Kalkas  may  not  be  scorched 
or  burnt.  This  medicinal  compound,  when  properly 
prepared,  should  be  removed  from  the  fire  and  when 
cooled  should  then  be  made  into  pills  (Gutika),  each 
being  an  Aksha  (two  Tolds)  in  weight.  These  pills 
should  be  given  once,  twice  or  thrice  daily  according  to 
the  exigency  of  the  case  and  the  capacity  of  the  patient 
for  a  period  of  three  or  four  consecutive  months.  The 
medicine  is  known  as  the  Anaiha-varti,  and  is  specially 
beneficial  in  cases  of  Mahd-vyddhi,  and  is  equally 
efficacious  in  destroying  intestinal  worms.  These 
pills,  if  regularly  used,  prove  beneficial  in  cases  pf 
cough,  asthma,  Kushtha,  parasites,  catarrh,  indigestion, 
aversion  to  food  and  Udavarta.     15. 

Second  Anstha- Varti  :  —The  inner  pulp  of 

the  seeds  of  Madana  fruits  with  Kutaja,  Jimutaka, 
Ikshvdku  (bitter  gourd),  Dhdmdrgava,  Trivrit^  Trikatu^ 
mustard  seed  and  rock-salt,  should  be  pasted  together 
with  either  the  milky  juice  of  Mahd-vriksha  or  with  the 
urine  of  a  cow ;  and  the  paste  should  be  made  into 
thumb-shaped  plugs  (Varti).  In  a  case  of  Anaha  of  the 
patient  already  suffering  from  Udara,  the  outer  end  of 
his  rectum  should  be  lubricated  with  oil  and  salt  and 
one  or  two  of  the  plugs  should  be  inserted  therein.  The 
application  of  this  Anaiha-varti  should  as  well  be 
applied  in  cases  of  Uddvarta,  due  to  a  suppression  or 
retention  of  stool,  urine,  and  Vata  (flatus)  and  in 
cases  of  tympanites  (Adhmdna)  and  distention  of  the 
abdomen  (Andha).     16. 

Treatment  of  Plihodara  :— In  a  case  of 

Plihodara,  *  applications  of  Sneha  (oil,  etc.)  and   Sveda 

*  Dropsical  swelling   of  the  abdomen  owing  to  an  enlargen^ent  of  the 
spleen^ 


Chap.  XIV  3  CHIKITSA  STHANAM.  399 

(  fomentations  )  should  be  made  and  the  patient 
should  be  fed  on  boiled  rice  mixed  with  milk-curd. 
Then  the  vein  (Sira)  inside  the  elbow  of  his  left  hand, 
should  be  duly  opened.  The  spleen  should  be  rubbed 
with  the  hand  for  the  proper  out-flow  of  its  deranged 
blood  (for  the  relief  of  that  enlarged  organ).  Then 
having  properly  cleansed  his  system,  the  physician 
should  advise  the  patient  to  take  the  alkali  of  marine 
oyster-shells  through  the  medium  of  milk.  As  an  alter- 
nditive,  Vava-ks/idra  should  be  given  to  himwithSauvarc/i- 
ikd  and  Hingu,  or  with  filtered  alkali  (made  with  the 
ashes)  of  Paldsa  wood.  As  an  alternative,  the  alkali 
of  Pdrijdtaka,  Ikshvdku  and  Apdmdrga^  mixed  with  oil, 
should  be  prescribed  ;  or  the  decoction  of  S'obhdnjana, 
mixed  with  Chitraka^Saindhava  d^adPippali, or  the  alkali 
of  Puti-karanja,  filtered  with  Kdnjika  and  mixed  with 
a  copious  quantity  of  Vid  salt  (black  salt)  and 
powdered  Pippali  should  be  administerd.     17. 

Shat-palaka  Ghrita  :— One  pala  weight  of 

each  of  the  following  drugs,  vizy  Pippali^  Pippali-roots^ 
Chitraka,  S'unthi,  Yava-kshdra  and  Saindhava  should 
be  cooked  with  one  Prastha  measure  of  clarified  butter 
and  the  same  quantity  of  milk*.  The  medicated  Ghrita 
thus  prepared  is  called  the  Shat-palaka-Ghrita.  It  is  high- 
ly efficacious  in  cases  of  an  enlargement  of  the  spleen, 
impaired  digestion,  Gulma,  dropsy,  Udavarta,  swelling 
(Svayathu),  jaundice,  cough,  asthma,  catarrh,  Urdhva- 
Vata  and  Vishama-Jvara.  In  cases  of  Udara  attended 
with  impaired  digestion,  the  Hingva'di  Churna  should  be 
prescribed.  These  measures  should  be  as  well  employ- 
ed in  a  case  of  an  enlargement  of  the  liver  (Yakrit), 
but  the  speciality   is   that  the  vein  (inside  the   elbow)  of 

*  The   practice,    in  this   case,  is    to  add  twelve   Seers  (three   prastha 
measures)  of  water  to  the  Prastha  measure  of  milk  at  the  time  of  cooking. 


400  THE  SUSHRUTA  SAMHITA.  [Chap.  XIV. 

the  right  hand  (instead  of  the  left  hand)  should  be  opened 
in  this  case.     i8. 

Metrical  Text :— After  slightly  bending  down 
the  wrist  (of  the  left  hand),  the  vein  in  connection  with 
the  thumb  of  the  left  hand  should  be  cauterized  with 
a  (burning)  Sara  for  the  purpose  of  giving  relief  in  a 
case  of  enlarged  spleen.     19. 

Treatment     of    Vaddha-gudodara, 

etc.  :  — In  cases  of  the  Vaddha-guda  (Entertis)  and 
the  Parisraivi  types  of  Udara,  the  patient  should  be 
first  treated  with  emulsive  measures  and  fomentations 
and  then  anointed  with  a  sneha.  Then  an  incision  should 
be  made  on  the  left  side  of  the  abdomen  below  the  um- 
bilicus and  four  fingers  to  the  left  of  the  line  of  hair  which 
stretches  downward  from  the  navel.  The  intestine  to  the 
length  of  four  fingers  should  be  gently  drawn  out  ; 
any  stone,  any  dry  hardened  substance  (Scybalum  ?), 
or  any  hair  found  stiffing  to  the  intestine  should  be 
carefully  examined  and  removed.  Then  the  intestine 
should  be  moistened  with  honey  and  clarified  butter. 
It  should  then  be  gently  replaced  in  its  original 
position  and  the  mouth  of  the  incision  in  the  abdomen 
should  be  sewn  up.     20. 

Treatment  of    Parisrsivi-Udara  :— In 

cases  of  the  Parisrsivi  type  of  Udara,  the  obstructing 
matter  should  be  similarly  removed  (from  the  intestines), 
as  in  the  preceding  case,  and  the  secreting  intestine 
should  be  purified.  The  (two  ends  of  the  severed 
intestines  should  be  firmly  pressed  and  adhered  toge- 
ther and  large  black  ants  should  be  applied  to  these 
spots  to  grip  them  fastly  with  their  claws.  Then  the 
bodies  of  the  ants  having  their  heads  firmly  adhering  to 
the  spots,  as  directed,  should  be  severed  and  the  intes- 
tines  should    be  gently  reintroduced    into  their  original 


Chap.  XIV.)  CHIKITSA  STHANAM.  401 

position  (with  the  severed  heads  of  the  ants  adhering  to 
the  ends  of  the  incision)  and  sutured  up,  as  in  the  prece- 
ding case.  A  union  or  adhesion  of  the  incidental 
wound  should  then  be  duly  effected.  The  «=eam  should 
now  be  plastered  with  black  earth  mixed  with  Yashti- 
madhu  and  duly  bandaged.  The  surgeon  should  cause 
the  patient  to  be  removed  to  a  chamber  protected  from 
the  wind  and  give  him  the  necessary  instructions.  The 
patient  should  be  made  to  sit  in  a  vessel  full  of  oil  or 
clarified  butter  and  his  diet  should  consist  only  of 
milk.     2r. 

Treatment  of   Udakodara  :— A  patient 

afflicted  with  Jalodara  (ascites)  should  be  first  anointed 
with  medicated  oils,  possessed  of  Vdyu-subduing  virtues, 
and  fomented  with  hot  water.  Then  his  friends  and 
relatives  should  be  asked  to  hold  him  firmly  by  his 
arm-pits,  when  the  surgeon  would  make  a  puncture  with 
a  surgical  instrument,  known  as  the  Vrihi-mukha,  on 
the  left  side  of  the  abdomen  below  the  umbilicus,  to  the 
breadth  of  the  thumb  in  depth  and  at  a  distance  of 
four  fingers  to  the  left  of  the  dividing  line  of  hairs 
in  the  abdomen,  Simultaneously  with  that,  a  metal 
tube  or  a  bird's  quill,  open  at  both  ends,  should  be 
introduced  through  the  passage  of  the  puncture  to  allow 
the  morbific  fluids  (Doshodoka),  accumulated  in  the 
abdomen,  to  ooze  out.  And  then  having  removed  the 
tube  or  the  quill,  the  puncture  should  be  lubricated  with 
oil  and  Saindhava  salt  and  bandaged  in  the  manner 
described  in  connection  with  the  bandaging  of  ulcers. 

The  entire  quantity  of  the  morbific  fluid  should  not 
be  allowed  to  ooze  out  in  a  single  day,  inasmuch  as 
thirst,  fever,  aching  of  the  limbs,  dysentery,  dyspnoea 
and  a  burning  of  the  feet  (Pdda-djiha)  might  supervene  in 
consequence,  or  as  it  might  lead  to  a  fresh  accumulation 

51 


402  THE  5USHRUTA  SAMHITA.  |[Chap.  XIV. 

of  matter  in  the  abdomen,  in  the  event  of  the 
patient  being  of  a  weak  constitution.  Hence  it  should 
be  gradually  tapped  at  intervals  of  three,  four,  five,  six, 
eight,  ten,  twelve,  or  of  even  sixteen  days.  After  the 
complete  outflow  of  the  fluid,  the  abdomen  should  be 
firmly  tied  with  a  piece  of  flannel,  silk-cloth  or 
leather,  inasmuch  as  this  would  prevent  its  flatulent 
distention. 

Diet;— For  six  months  the  patient  should  take 
his  food  only  with  milk  or  with  the  soup  (Rasa)  of 
Jdngala  animals. 

The  diet*  for  the  next  three  months  should  consist  of 
(meals  taken  with)  milk  diluted  (and  boiled)  with  an 
equal  quantity  of  water  or  with  the  soup  of  flesh  of 
animals  of  the  Jdngala  group  seasoned  with  the  juice 
of  acid  fruits.  During  the  next  three  months  it  .should 
consist  of  light  and  wholesome  meals.  This  rule 
observed  for  a  year  brings  about  a  cure.     22. 

IVIemorable      Verse  :— Skilled    physicians 

should   prescribe    boiled    milk  and  the  soup  of  the  flesh 


*     The  use  of  water  is  forbidden  during  these  nine  months. 

During  ihe  first  six  months,  drinking,  washing,  etc.,  should  be  done 
with  milk  or  the  soup  of  Jangala  animals.  After  this  period,  the  said 
purposes  should  be  served  with  half.diluled  milk  or  meat-soup  seasoned 
with  the  juice  of  acid  fruiis.  Water  may  be  used  during  the  period  of 
the  next  three  months. —Dallana. 

Vagbhata  following  Charaka  says:  — 

The  patient  should  live  only  on  milk  for  six  months.  After  this 
period,  he  should  live  on  porridge  (Peya)  boiled  with  milk  ;  and  for  the 
next  three  months  he  shoull  live  on  boiled  S'y^ma-rice  with  milk, 
or  with  the  soup  of  meat  seasoned  with  the  juice  or  acid  fruits  and  mixed 
with  clarified  butter  and  a  small  quantity  of  salt. 

The  water  of  tender  and  green  cicoanuts  is  used  in  cases  of  Udara 
in  place  of  pure  drinking  water  with  benefit. — Ed. 


Chap.  XIV.]                 CHlkltSA  STHANAM.  403 

of  animals   of  the    Jdngala   group   as    food  and   drink 

in    all    cases   of  Udara    and    use   these   as  Asthapana 
measures  and  as  purgatives  as  well.     23. 


Thus   ends   the  fourteenth   Chapter   in  the  Chikitsita  Sth^nam  of  the 
Sus'rula  Samhitd  which  deals  with  the  treatment  of  Udara. 


CHAPTER  XV. 

Now  we  shall  discourse  on  the  (surgical  and  medical) 
treatment  of  the  cases  of  difficult  malpresentation  of  the 
foetus  and  of  difficult   labour  (Mudha-Garbha).     i. 

The  extraction  of  a  foetus,  acting  (^in  the  womb)  as 
an  obstructing  Salya  (foreign  matter  lodged  in  the  body), 
is  the  most  difficult  of  all  surgical  operations,  inasmuch 
as  actual  contact  or  actual  manipulation  is  the  only 
means  accessible  to  a  surgeon  in  the  region  of  the  pelvic 
cavity,  the  spleen,  the  liver,  the  intestines  and  the 
uterus.  All  surgical  acts  in  respect  of  the  foetus  or  the 
enceinte,  such  as  lifting  up,  drawing  down,  changing  of 
postures  (version),  excision,  incision,  the  cutting  of  limbs 
and  section,  pressure,  the  straightening  and  the  perforat- 
ing of  the  abdomen,  could  not  be  done  otherwise  than  by 
actual  contact  of  the  hand,  which  may  sometimes 
prove  fatal  to  the  foetus  or  to  the  enciente.  Hence  the 
king  should  be  first  informed  (as  success  in  these  cases 
is  often  uncertain)  and  all  acts  should  be  performed 
with  the  greatest  care  and  coolness. 

We  have  stated  before  that  the  foetus  is  generally 
presented  in  cases  of  difficult  labour  in  eight  different 
postures  or  forms.  The  obstruction  of  the  child  in  the 
passage  of  parturition  (Garbha-Sanga)  may  be  effected 
in  three  different  ways,  owing  to  its  head,  shoulders  or 
hips  being  presented  in  a  wrong  way  and  held  fast  in 
the  passage.  Every  care  should  be  taken  and  no  pains 
spared  to  bring  a  child  alive  into  the  world,  which  is  not 
already  dead  in  the  womb.  The  sacred  verses  (Mantras), 
possessing  of  the  virtue  of  bringing  out  the  foetus,  should 
be  recited  in  the  hearing  of  the  enciente  in  the  case  of  a 


dhap.  XV.]  CHlklTSA  STHANAM.  4O5 

failure  in  the  first  attempts  at  effecting  parturition. 
The  mantras  are  as  follows.     2. 

Metrical  Texts  :— ''O  thou  beautiful  damsel, 
may  the  divine  ambrosia'  and  the  Moon  god  with  Chitra- 
bhdnu  and  the  celestial  horse  Uchchaih-Sravas  take 
their  residence  in  thy  room  ;  may  this  water-begotten 
nectar,  help  thee,  O  lady,  in  swiftly  casting  off  thy  womb. 
May  the  Sun,  the  Vdsavas  and  the  Wind-god  (Favana) 
in  the  company  of  the  saline  Ocean  give  thee  peace. 
The  incarcerated  beasts  have  been  freed  from  their 
fastenings  and  binding  chords.  The  Sun  god  has  freed 
his  rays  of  light.  Freed  from  all  danger,  come,  O, 
come,  O  child,  and  rest  in  peace  in  these  precincts,"     3. 

Proper  and  useful  medicinal  remedies  should  also  be 
employed  for  the  delivery  of  the  child. 

Postures  of  the  Foetus:— In  the  case  of  the 

foetus  being  dead  in  the  womb,  the  enciente  should  be 
made  to  lie  on  her  back  with  her  thighs  flexed  down 
and  with  a  pillow  of  rags  under  her  waist  so  as  to  keep 
it  a  little  elevated.  Then  the  physician  should  lubri- 
cate his  (own)  hand  with  a  compound  consisting  of  earth, 
clarified  butter  and  (the  compressed  juice  of)  S'allaki^ 
Dhanvana  and  S'dhnali  and  inserting  it  into  the  passage 
of  parturition  (Yoni)  should  draw  out  the  dead  foetus 
(downward  with  the  hand).     4. 

In  the  case  of  a  leg-presentation  (Sakthi),  the  foetus 
should  be  drawn  downward  by  pulling  its  legs.  In  case 
where  a  single  leg  (Sakthi)  is  presented,  the  other  leg  of 
the  foetus  should  be  expanded  and  then  it  should  be 
drawn  downward. 

In  the  case  of  the  presentation  of  the  buttccks(Sphik). 
I  breech  presentation),  the  buttocks  should  be  first  pressed, 
and  lifted    up   and    then    the   foetus    should    be    drawn 
downward   by   the  legs.     In  the  case  of  a  longitudinal 


406  THE  SUSHRUTA   SAMHITA,  [Chap.  XV, 

presentation  (the  child  coming  stretched  cross-wise)  like 
a  belt  and  arrested  in  the  passage,  its  lower  extremities 
should  be  pushed  upward  with  the  hand  and  the  child 
should  be  drawn  out  with  its  upper  part  (viz.,  the  head, 
etc.),  thus  pointed  downward,  and  brought  straight  into 
the  passage  of  parturition.  In  a  case  of  the  head  being 
hung  back  a  little  on  one  side,  the  shoulder  should  be 
lifted  up  by  pressing  it  (with  the  hand)  after  chafening 
it,  so  as  to  bring  the  head  at  the  door  of  the  passage 
and  the  child  should  be  drawn  straight  downward. 
Similarly  in  the  case  of  the  presentation  of  the  two 
arms,  the  shoulder  should  be  lifted  up  by  pressing  it 
(with  the  hand)  and,  the  head  being  brought  back  to 
the  passage,  the  child  should  be  drawn  downward. 
The  remaining  two  kinds  of  false  presentation 'Mudha- 
garbha)  previously  described  (in  the  eighth  Chapter  of 
the  Niddna  Sthana)  should  be  considered  as  irreme- 
diable. The  applications  of  instruments  (Sastra)  should 
be  the  last  resort  when  such  manipulatory  measures 
would  fail.     5. 

IVletrfCal  Text  :  —But  even  in  such  irremediable 
(Asadhya)  cases,  surgical  operations  should  not  be  made 
if  the  foetus  could  be  detected  alive  in  the  womb,  as 
such  a  course  (as  the  cutting  of  the  foetus,  etc.)  would 
fatally  end  both  as  regards  the  child  and  its  mother.    6. 

Operations  involving  destruction  of 
the  Foetus— Craniotomy :- In   cases   where 

there  would  be  any  necessity  of  using  an  instrument  for 
the  purpose  of  delivery,  the  enciente  should  be  en- 
couraged (with  hopes  of  life)  before  making  the  surgical 
operation.  The  head  or  skull  of  the  child  in  such 
cases  should  be  severed  with  the  knife  known  as  the 
Mamlaldgra  or  the  Anguli-^astra  ;  then  having  carefully 
takdrt     out   the   particles   of    the  skull-bone   (Kap^la), 


Chap.  XV.3  CHIKITSA  STHANAM.  40/ 

the  foetus  should  be  drawn  out  by  pulling  it  at  its  chest 
or  at  the  shoulder  with   a   Sanku    (forceps).    Where  the 
head    would    not    be   punctured  and  smashed,  the  foetus 
should  be  drawn  out  by  pulling  it  at  the    cheeks   or   the 
eye-sockets.     The  hands  of  the  foetus  should  be  severed 
from  the  body  at  the  shoulders,  when  they  (the  shoulders) 
would    be   found  to  have  been  obstructed  in  the  passage 
and  then  the  foetus  should  be  drawn  out.     The  abdomen 
of  a  child,  dead    in  the  womb,  should  be  pierced  and  the 
intestines  drawn  out,  in  event  of  the  former  being  swollen 
into    a    flatulent  (Vdta)  distension  like  a  leather  bag  vfor 
holding   water),   as   such  a  procedure  would  remove  the 
stiffness  of  its  limbs,  and  then  it  should  be  drawn  out.    The 
bones  of  the  thighs  ( Jaghana-kapala)  should  be  first  cut 
out  and  removed,  where  the  foetus  would  be  found  to  have 
adhered  fast  to  the  passage  with  its  thighs  ijaghana).    7. 
lYIetrical  Texts  :— in  short,    that    part  of  the 
body   of  the    foetus    should    be    severed    and    removed 
which  (prevents  its    (foetus)  withdrawal  from  the  womb 
and    the   life   of    the    mother   should    be    saved   at    all 
hazards.      The     different    types   of    false-presentations 
should   be   ascribed    to   the    abnormal  coursing   of  the 
deranged    Vayu  (in  the  uterus),  and  hence  an  intelligent 
physician    should    adopt,     after   careful    considerations, 
proper   remedies    (for    its   pacification).     An  intelligent 
physician    should  not  waste  a  single  moment  in  drawing 
out   the    foetus,  as  soon  as  it  would  be  found  to  be   dead 
in    the   womb,    since  neglect    in  such  cases  leads  to  the 
instantaneous  death  of  the  mother,  like  an  animal  dying 
of  suffocation.     An    erudite    physician,   well-versed    in 
a'natomy,  should  use  in  such  cases  a  MandaUgra  instru- 
ment    for   the  purpose  of  cutting  out  '.the  foetus),  since 
a   sharpe-edged    Vriddhi-patra    may  sometimes  hurt  the 
mother  during  the  operation.      9-10. 


408  THE   SUSHRUTA  SAMHITA.  [Chap.  XV. 

A  non-falling  placenta  (Aparai)  should  be  extracted 
in  the  way  indicated  before  or  the  enciente  should  be 
firmly  pressed  and  the  placenta  extracted  with  the 
hand.  Her  body  should  be  constantly  shaken  or 
her  shoulders  constantly  rubbed  at  the  time  (of 
extracting  the  placenta')  after  lubricating  the  passsage 
of  parturition  with  oil.     i  r . 

After- measures  :— Thus  having  extracted 
the  Salya  (foetus^,  the  body  of  the  mother  should  b^ 
washed  with  warm  water  and  anointed  with  oil,  etc. 
Oil  should  also  be  copiously  applied  to  the  passage  of 
parturition  *  as  it  would  soften  the  Yoni  and  alleviate 
the  pain  therein.  After  that,  powdered  Pippali, 
Pippali-roots^  S'unthi,  Eld^  Hingii^  Bhdrgi,  Dipyaka, 
Vachd,  Ativishd,  t<dsnd  and  Chavya  should  be  given 
in  a  Sneha  (clarified  butter,  etc.),  for  the  (proper) 
discharge  (2>.,  purification)  of  the  Uoshas  (lotia)  and  for 
the  alleviation  of  the  pain.  A  plaster,  or  a  decoction,  or 
a  pulverised  compound  of  the  said  drugs  without  the 
addition  of  any  Sneha  (clarified  butter,  etc.)  may  also  be 
given  to  her.  As  an  alternative,  the  physician  should 
ask  the  parturient  woman  to  take  S' dka-hdixV^  Hingu, 
Ativishd,  Pdthd,  Katu-rohini  and  Tejovati  prepared  and 
administered  in  the  preceding  manner.  Then  for 
three,  five  or  seven  days,  Sneha  (clarified  butter,  etc.) 
should  again  be  given  ;  or  the  patient  should  be  asked 
to  take  well  prepared  Asavas  and  Arishtas  at  night  time. 
A  decoction  of  the  bark  of  S'irisha  and  Kakubha 
should  be  used  for  washing  (Achamanaf)  purposes  and 
the  other  supervening  distresses  {i.e.^  complications) 
should  be  remedied  with  proper  medicines..     12- A. 

*  The  oil  should  be  introduced  into  the  vaginal  canal  by  means  o. 
PicllUt  i  e.y  cotton  plugs  soaked  in  oil,  etc. 

t  This  decoction  should  be  specially  used  for  1  washing  the  uterus 
(Yoni).— Ed. 


Chap.  XV.]  CHIKITSA  STHANAM.  .469 

Diet  and  regimen  of  conduct :— The 

mother  should  always  be  neat  and  clean  and  subjected 
to  a  course  of  a  small  quantity  of  wholesome  and 
emollient  diet  and  to  daily  anointments  and  foment- 
ations ;  and  she  should  be  advised  to  renounce  all  anger. 
Milk  cooked  with  the  Viyu-subduing  drugs  should  be 
used  for  the  first  ten  days.  Meat-soup  should  then  be 
prescribed  for  another  such  period,  after  which  a  diet 
should  be  prescribed  according  to  the  patient's  health 
and  nature.  This  regimen  should  be  observed  for  a 
period  of  four  months,  after  which,  the  patient  would 
be  found  to  have  regained  her  health,  strength  and 
glow  of  complexion,  without  any  complications,  when  the 
medical  treatment,  etc  ,  should  be  discontinued.  12-14. 

The  following  Vald-Taila  should  be  used  for  apply- 
ing into  the  Yoni  (Vagina,  etc.),  for  anointing  the  body 
and  for  drinking  and  eating  purposes  (i.e.,  along  with 
other  food)  as  well  as  for  Vasti-Karma,  as  the  oil  is 
highly  efficacious  in  curbing  the  action  of  the  deranged 
and  aggravated  bodily  Va(yu.     15— A. 

The  ValSL  Taila  :  -*  An  adequate  quantity  of 
sesamum  oil  should  be  cooked  with  eight  times  as  much 
of  the  decoction  of  each  of  the  following  ;  viz.,  Vald 
roots,  Dasa-mula  and  the  three  combined  drugs  of  Yava^ 
Kola  and  Kulattha  and  with  eight  times  as  much  of 
milk  and  (one-fourth  as  much  of)  a  paste  (Kalka)  com- 
pound of  the  drugs  included  in  the  Madhura  group  as 
well  as  with  Saindhava-sdXt,  Aguru,  Sarja-rasa,  Sarala- 
Kdshtha^  Deva-ddru,    Manjishthd,   Chandana^  Kushthay 

*  Four  seers  of  sesamun  oil,  thirty-two  seers  of  the  decoction  of  the 
Vala-roots,  thirty-two  seers  of  the  decoction  of  Das'a-mula,  thirty-two 
seers  of  the  decoction  of  the  drugs  Yava,  Kola  and  Kulattha  taken 
together,  thirty-two  seers  of  milk  and  one  seer  of  the  paste  compound 
(Kalka)  should  be  taken  in  the  preparation  of  the  oil. 

52 


410  THE  SUSHRUTA  SAMHITA.  [Cihap.  XV. 

Eld^  Kdldnusdrivd,  Mdnsi,  S' alley  a,  Teja-patra,  T agar  a, 
S'drivd^  Vachd^  S'atdvari,  As'va-gandhd,  S'dta-pushpd 
and  Punarnavd.  After  the  completion'  of  its  cooking 
the  oil  should  be  kept  carefully  in  a  golden,  silver,  or 
earthen  pitcher  with  its  rnouth  well-stoppered.  This  oil 
is  known  as  the  Valai-Taila  and  proves  curative  in  all 
diseases  due  to  the  action  of  the  deranged  Vdyu.  A 
newly  delivered  woman  should  use  this  oil  in  adequate 
doses,  according  to  her  physical  condition.  Women 
wishing  to  be  mothers  and  men  seeking  the  blessings 
of  fatherhood  should  use  this  Taila,  which  proves 
equally  beneficial  in  cases  of  an  emaciation  of  the  body 
due  to  the  action  of  the  deranged  Vayu,  weariness  of 
the  body  through  hard  labour,  and  also  in  cases  of  hurt 
or  injury  to  any  vital  and  vulnerable  part  of  the  body 
(Marma),  in  cases  of  fractured  bones,  convulsions,  Vata- 
Vyddhi,  hiccough,  cough,  Adhimantha,  Gulma  and 
dyspnoea.  A  case  of  hernia  would  likewise  yield  to  the 
continuous  use  of  this  oil  for  six  months.  The  essential 
and  vital  principles  (Dhatus)  of  the  organism  of  a  man 
are  strengthened  through  its  use  and  his  youth  will 
suffer  no  decay.  It  should  be  used  alike  by  kings,  king- 
like and  wealthy  persons,  as  well  as  by  those  of  a 
delicate  and  ease-loving  temperament.     15— B. 

The  Vala-Kalpa  :— Seeds  of  sesamum 
should  be  successively  soaked  a  number  of  times  in  a 
■decoction  of  Vald  roots*  and  then  dried  (in  the  manner 
of  a  Bhavana  saturation).  The  oil  pressed  out  of  such 
sesamum  should  be  successively  cooked  a  hundred  times 
with  the  decoction  of  Va/d-roots.  This  being  done,  the 
oil  should  bs  poured  into    an  earthen    pitcher   and   the 

*  Vala  wouM  be  the  Kalka  in  this  oil,  says  Dallana.  But  he  also  says 
that  some  authorities  hold  that  the  Kalkas  used  in  the  Vala-Taila  should 
be  used  as  the  Kalka  in  this  oil  as  well. 


Chap.  XV.]  CHIKITSA  STHANAM,  4II 

patient,  while  taking  it  in  adequate  doses,  should  live 
in  a  lonely  chambsr  protected  from  the  wind.  After  its 
digestion,  the  patient  should  partake  of  milk  and  boiled 
Shashtika  rice.  A  Drona  measure  of  the  oil,  should  in 
this  way,  be  gradually  taken  and  the  regimen  of  diet 
(milk  and  Shashtika  rice,  etc.)  should  be  observed  for 
double  that  period.  This  oil  is  efficacious  in  improving 
one's  strength  and  complexion  and  adds  a  century  (of 
years)  to  the  duration  of  one's  life,  and  at  the  same  time 
absolves  him  from  all  sins.  It  is  said  that  the  use  of  each 
succesive  Drona  measure  of  this  oil  adds  a  century  to 
one's  days  on  earth.     16. 

Oils  may  similarly  be  prepared  with  each  of  Ativishd^ 
Guduchi,  Aditya-parni^  Saireyaka,  Virataru,  S'atdvari^ 
Tri-kantaka,  Madhuka  and  Prasdrani,  and  may  be 
prescribed  by  an  experienced  and  erudite  physician.    17. 

Nilotpala  and  S^atdvari  should  be  cooked  in  milk. 
The  milk  thus  prepared  should  be  again  cooked  with 
sesamum  oil  successively  a  hundred  times  and  a 
paste  of  all  the  drugs  used  as  a  paste  in  the  Vala^  Taila 
should  be  added  to  it  at  the  time  of  cooking.  The 
therapeutic  virtues  of  all  these  oils  are  the  same  as 
those  of  the  Vald-Taila  and  the  same  regimen  of  diet 
and  conduct  should  be  observed  in  all  such  cases.     18. 

Thus  ends  the  fifteenth  Chapter  of  the  Chikitsita  Sthanam  in  the 
Sus'ruta  Samhita  which  deals  with  the  medical  treatment  of  Mudha- 
garbha. 


CHAPTER     XVI. 

Now  we  shall  discourse  on  the  medical  treatment 
of  Abscesses  and  Tumours  (Vldradhl).      i. 

Of  the  six  types  of  Vidradhis,  the  one  of  the  Sanni- 
pdtika  type  should  be  regarded  as  incurable  In  all 
other  types  curative  measures*  should  be  speedily 
resorted  to  in  their  unsuppurated  stage,  as  in  the  treat- 
ment of  a  case  of  Sopha  (inflammatory  swelling  or 
boil).  2. 

Treatment  of  Vataja-Vidradhi  :— in 

a  case  of  Vdtaja  Vidradhi,  a  compact  or  thick  plaster 
(Alepa)  composed  of  pasted  Murang'i-r oots,f  mixed 
with  clarified  butter,  oil  and  lard  (Vasa),  should  be 
applied  lukewarm.  The  flesh  of  the  animals  which 
frequent  swamps  and  marshes  as  well  as  of  aquatic  ani- 
mals boiled  with  the  drugs  of  the  Kdkolyddi  group, 
Kdnjika,  salt,  barley  powder  and  Sneha  (clarified 
butter,  &c.),  should  be  applied  as  a  poultice  (Upandha>, 
and  the  affected  part  should  be  constantly  fomented 
with  (warm)  Ves'avdra,  Kris'ara,  milk  and  Payasa. 
Blood-letting  should  also  be  resorted  to.     3. 

If,  in  spite  of  the  use  of  the  preceding  remedies, 
'suppuration  should  begin  to  set  in,  suppurating  measures 
should  be  resorted  to   and    the    abscess    (finally)  lanced 

*  Commencing  with  Apatarpana  up  to  purgative  measures  (Chikitsd, 
chapter.— I ). 

t  Both  Dallana  and  Chakrapani  Datta  read  "Vataghna"  in  place  of 
**Murangi"  of  the  text.  Dallana  explains  the  term  "Vataghna"  as  the 
•'Bhadra-darvadi  group"  and  S'iva-dasa,  the  commentator  of  Chakrapani, 
explains  it  as  the  "Das'a-mula".  Both  of  them,  however,  say  that  he 
different  reading  is  "Surangi"  meaning  "S'obhdnjana."  **Murangi"  also 
means  "S'obhdnjana."— Ep. 


Chap.  XVI.]  CHIKITSA  STHANAM.  413 

With  a  knife.  Cleansing  measures  should  then  be  applied 
to  the  (incidental)  ulcer.  After  incision,  the  ulcer 
should  be  washed  with  a  decoction  of  the  Pancha-mula  ; 
and  an  oil  cooked  with  the  drugs  of  the  Bhadra-ddrvddi 
group  and  Yashti-madhu,  and,  mixed  with  an  abundant 
quantity  of  salt,  should  be  used  in  filling  (healing  up) 
the  cavity  of  the  wound.  The  cleansing  of  the  ulcer 
should  be  effected  with  the  powdered  Vairechanika 
(purgative)  drugs  mixed  with  Traivrita*  and  the 
healing  should  be  effected  with  Traivrita  cooked  with 
the  drugs  of  the  Prithak-parnyddi  group.     4-6. 

Treatment  Of  Pittaja  Vidradhi:— In  a 

case  of  Pittaja  Vidradhi  a  plaster  (Pradeha)  composed 
of  sugar,  fried  paddy,  Yashti-Madhu  and  Sdrivd  pasted 
with  milk  should  be  applied,  As  an  alternative,  a 
plaster  composed  of  Payasyd,  Us'ira  and  (red)  sandal 
wood  pasted  with  milk  should  be  used.  Cold  infusions 
of  Pdkya  (Yava-kshdra),  sugarcane-juice  and  milk,  and 
jivaniya-Ghrita  mixed  with  sugar  should  be  used  in 
affusing  the  abscess.  The  patient  should  be  advised  to 
lick  a  lambative  composed  of  powdered  Haritaki 
and  Jrivrit  saturated  with  honey  ;  and  leeches  should 
be  applied  (to  an  unsuppurated)  abscess  for  letting  out 
the  blood.  An  intelligent  surgeon  should  (lance  a 
suppurated  abscess  and)  wash  the  incidental  ulcer  with  a 
decoction  of  Kshira-Vriksha  or  of  aquatic  bulbs. 
Poultices  of  sesamum  and  Yashti-Madhu  mixed  with 
honey  and  clarified  butter  should  then  be  applied  to 
it  and  bandaged  with  a  piece  of  thin  linen.  Clarified 
butter  cooked  with  Prapaundarika^  Mmtjishtha, 
Yashti-Madhu,    Us'ira,   Padmaka^   Haridrd  and  milk, 

*  "Traivrita"  is  a  technical  term  and  means  clarified  butter  mixed 
with  the  three  other  lardacious  substances,  viz.,  oil,  lard  and  marrow. 
Vide  Chikitsita  Sthdnam.     Chapter— V. 


414  THE   SUSHRUTA  SAMHITA.  [Chap.  XVI. 

should  be  used  to  heal  up  the  cavity  of  a  Pittaja 
ulcer,  by  (inducing  granulation).  As  an  alternative, 
clarified  butter  cooked  with  Kshira-S'ukld,  Prithak- 
parni,  Samangd,  Rodhra^  Chandana  and  the  tender 
leaves  and  bark  of  the  drugs  of  the  Nyagrodhddi  group 
should  be  employed  for  the  same  end.     7-10. 

Karanjadya  Ghrita  :— A  Karsha  measure 

of  each  of  the  following  drugs,  viz.,  the  tender  leaves  and 
fruits  of  thQ]Naktamdla,  the  leaves  of  the  Sumana  (Jdti 
flower),  Patola  and  of  Arishta,  Haridrd,  Daru-Haridrd, 
wax,  Yashti-Madhu,  Tikta-Rohini,  Priyangu?  Kus'a- 
roots,  Nichula-hdiXk,  Manjishthd^  sandal  wood,  Us'ira^ 
Utpala,  Sdrivd  and  Trivrit  should  be  cooked  with  a 
Prastha  measure  of  clarified  butter.  This  medicated 
Ghrita  is  called  the  Karanjaidya  Ghrita,  and  it 
will  cure  malignant  ulcers  (Dushta-Vrana)  and  act  as  a 
purifier  in  sinus  and  recent  ulcers,  etc.,  burns  and  scalds, 
deep  sores  and  even  deep-seated  sinuses.     1 1. 

Treatment  Of  Kaphaja  Vidradhi  :— In 

a  case  of  Kaphaja  Vidradhi,  the  seat  of  affection  should 
be  fomented  with  a  heated  brick,  sand,  iron,  cow-dung, 
husks,  ashes  and  cow's  urine.f  The  Doshas  involved 
in  such  a  case  should  be  curbed  down  by  a  constant 
use  of  medicinal  decoctions,  emetics,  plasters  (Alepa) 
and  poultices  (Upanaha).  The  vitiated  blood  of  the 
locality  should  be  cuffed  out  with  an  Aldvu-yantra 
(gourd).    The  abscess  when  suppurated  should  be  (lanced 

*  Chakrapani  Datta  in  his  compilation  does  not  include  Priyangu, 
Kus'a-roots  add  Nichula-bark  in  the  list  but  he  reads  both  the  kinds  of 
sariva,  i.  e.,  Anantamula  and  S'yamd-lata. 

t  In  Chakradatta,  the  reading  is  '%(^fq^;"  i.e.,  pasted  in  cow's  urine» 
instead  of  ♦•^pg^i^;"  I  S'ivaddsa,  the  commentator,  however,  holds  that 
this  reading  is  not  authoritative,  though  he  says  that  some  commentators 
have  accepted  it. 


I 


Chap.  XVI.]  CHIKITSA  STHANAM.  41S 

and)  washed  with  a  decoction  of  hragvadha.  The 
sore  of  such  an  ulcer  should  be  filled  up  (healed)  with  a 
medicinal  compound  consisting  of  the  paste  of  Haridrd 
Trivrit,  S'aktu,  sesamum  and  honey  and  bandaged  in 
the  manner  described  before.  After  that,  a  medicated 
oil  properly  cooked  with  a  paste  of  Kulatthikd,  Danii^ 
Irivrit:  S'ydmd,  Arka,  Tilvaka,  cow's  urine  and  rock- 
salt  should  be  applied  in  such  a  case.    12-13. 

Treatment  of  Agantuja  and  Raktaja 

Vidradhi  :— In  a  case  of  abscess  of  traumatic 
(Agantuja)  origin,  or  due  to  the  vitiated  condition  of  the 
blood  (Raktaja),  all  the  measures  and  remedies  laid 
down  in  connection  with  those  of  the  Pittaja  type 
should  be  employed  by  a  skilled  surgeon.  14 

Treatment  of  internal  Vidradhi  :— A 

case  of  an  unsuppurated  internal  abscess  yields  to  the  use 
of  a  potion  consisting  of  a  decoction  of  the  drugs  of 
the  Varunddi  group  saturated  with  the  powders  (Kalka) 
of  those  of  the  Ushakddi  group.  Clarified  butter 
cooked  with  the  decoction  of  the  drugs  of  the  two 
preceding  groups,  as  well  as  clarified  butter  cooked  with 
purgative  |drugs,  taken  every  morning,  will  cure  an 
internal  abscess  in  a  very  short  time.  The  decoctions 
of  the  above  groups  should  be  mixed  with  Sneha  (oil  or 
clarified  butter)  and  speedily  used  as  an  Asthdpana  as 
well  as  an  Anuvasana  measure.  The  hsirk  o{  Mad/m-s'tgru 
mixed  with  the  powders  of  the  drugs  antidotal  to  the 
Doshas  involved  in  the  case,  being  administered  in  food 
and  drink  and  used  as  a  plaster,  proves  curative  in  a 
case  of  an  internal  abscess  in  its  unsuppurated  stage. 
As  an  alternative,  the  said  drug  (i.e.,  Madhu-s'igru)  should 
be  taken  with  water,  Dhdnydmla,  cow's  rine,  or  Surd 
(wine).  Purified  S'ildjatu,  Guggulu^  S'unthi,  or  Deva- 
^«V«,  dissolved  in  the  decoction  of  the  drugs  antidotal  to 


4l6  THE  SUSHRUTA  SAMHITA.  [Chap.  XVI. 

the  aggravated  Doshas  involved  in  the  case,  should  be 
administered.  Applications  of  poultices,  Sneha-Karma 
(emollient  measures),  as  well  as  Anulomana  (Vayu-sub- 
duing)  measures  should  be  frequently  resorted  to  in 
such  cases.     15-20. 

The  veins  (S'ira)  should  be  opened  in  a  case  of  the 
Kaphaja  type  of  abscess  as  directed  before  ;  while 
some  authorities  advise  to  open  the  veins  at  the  arms  in 
cases  of  Raktaja,  Vataja  and  Pittaja  types.    21. 

Treatment  of  Suppurated   internal 

Vidradhi  :— A  suppurated  internal  Vidradhi  having 
bulged  up  (above  the  surface  of  the  body)  should  be 
opened  with  a  knife  and  treated  in  the  manner  of  an 
(incidental)  ulcer.  Whether  the  pus  drains  through  the 
lower  or  the  upper  channel  of  the  body  (rectum  or 
mouth)  the  patient  should  be  made  to  take  the  drugs  of 
the  Varunddi  group  or  Madhu-s'igru  mixed  with  (a 
copious  quantity  of)  Maireyay  Sura,  Asava,  or  Kanjika. 
The  diet  should  consist  of  rice  boiled  and  cooked  with 
white  mustard  seed  in  the  decoction  of  Madhu-s'igru 
and  taken  with  the  soup  of  barley,  Kola  and  Kulalttha 
pulse.  The  Tilvaka  Ghrita  (Chikitsa  Sthdna,  ch.  IV.), 
or  clarified  butter  cooked  with  the  decoction  of  the 
Trivritddi  group,  should  be  taken  every  morning  in 
adequate  doses  for  the  purpose.  Particular  care  should 
be  taken  by  the  phsyician  to  guard  against  the  suppura- 
tion of  an  internal  abscess,  since  suppuration  in  such 
cases  leads  but  to  a  slender  hope  of  success.     22-23. 

Treatment  of  IVIajja-Jata  Vidradhi  : 

— The  medical  treatment  of  a  patient,  afflicated  with  a 
Majja-jata  abscess  (abscess  affecting  the  marrow),  should 
be  taken  in  hand  without  holding  out  any  definite  hope 
of  recovery  fas  a  proper  course  of  treatment  in  such 
cases  does  not  invariably  prove  successful).  Sneha-karma 


Chap.   XVI. J  CHIKITSA   STHANAM.  417 

(anointments,  etc.)  and  fomentations  should  be  first 
resorted  to,  after  which  blood-letting  should  be 
made  ;  and  the  remedial  measures  of  the  present 
chapter  should  be  then  employed.  When  it  reaches  the 
suppurating  stage,  the  bone  should  be  operated  upon, 
and  after  the  full  elimination  of  the  pus  and  the  putrid 
matter  from  the  incised  ulcer,  purifying  remedies  should 
be  employed.  The  incidental  ulcer  should  be  washed 
with  the  decoction  of  the  bitter  drugs  and  the  Tikta- 
Sarpis*  should  be  ujed.  An  intelligent  physician 
should  apply  the  decoction  of  the  drugs  of  the 
Samsodhaniya  group,  if  the  oozing  out  of  the  marrow 
is  not  arrested.  A  medicated  oil  cooked  with  Priyangu, 
Dhdtaki,  Rodhra,  Katphala,  Nemi\  and  Saindhava 
salt  should  be  used  in  healing  up  an  ulcer  incidental 
to  an  opened  up  Vidradhi.     24-25. 

Thus  ends   the    sixteenth   Chapter    of  the  Chikitsita  Sthanam  in  the 
Sub'ruta  Samhila  which  deals  with  the  treatment  of  abscess. 


*  This  medicated  Ghrita  (Chikitsita  Sthdnam,  Ch.  IX)  may  be  used 
both  internally  and  externally   with  good  results.    Ed. 

t  Dallana  reads  "Tini"  in  place  of  "Nemi,"  both  of  which,  however, 
mean  "Tinib'a".  Chakradatta  does  not  include  "Saindhava"  in  the  list,  but 
reads  "Tinio'a-twacham"  in  place  of  "Nemi-Saindhavam".  S'ivad^sa, 
however,  adds  another  reading  'Tinis  'am  Dhavam"  on  the  authority  of 
Chandrala. 


-0-: — 


53 


CHAPTEE  XVII. 

Now  we  shall  discourse  on  the  medical  treatment  of 
erysipelas,  etc.,  (Visarpa),  sinus,  etc.,  (Nadl- 
Vrana)     and     diseases     of     the    mammary     glands 

(Stana-roga).  i. 

Of  the  types  of  erysipelas  (Visarpa)  the  first  three 
(viz.,  the  Vdtaja,  Pittaja  and  Kaphaja  ones)  are  curable  ; 
the  two  remaining  types,  viz.,  those  caused  by  the  con- 
certed action  of  the  three  Doshas  (of  the  body)  and 
those  originating  from  wounds  (Kshataja)  should  be 
considered  as  incurable.  In  cases  of  the  curable  types, 
medicated  Ghritas,  plasters  (Upadehas)  and  affusions 
(Seka)  prepared  with  the  drugs  (antidotal  to  the  specific 
aggravated  Dosha  or  Doshas  (involved  in  the  case) 
should  be  prescribed.     2. 

Treatment    of    Vataja   Visarpa  :~ln 

cases  of  the  Vsitaja  type  of  the  disease,  Mustd,  S'atdhvd, 
Sura-ddru,  Kushtha,  Vdrdhi,  Kustumhuru  (Dhanyaka) 
Krishna-gandhd,  and  the  drugs  of  a  heat-making  potency 
(Ushna-gana)*  should  be  used  in  preparing  the  medicinal 
washings  (Seka),  plasters  and  Ghritas.  The  drugs  res- 
pectively included  within  the  groups  of  the  Vrihat- 
Pancha-mula  and  the  Svalpa-Pancha-mula,  the  Kantaka- 
Pancha-mula  and  the  Valli-Pancha-mula  should  be 
(separately)  used  to  prepare  the  medicinal  plasters, 
affusions,  medicated  Ghritas  and  as  well  as  the  neces- 
sary oils.     3. 

*  Chakradatta  reads  "Arka",  Vams'a  and  Artagala  instead  of  the 
drugs  of  a  heat-making  potency.  Dallana  explains  the  drugs  of  a 
heat-making  potency  to  be  the  drugs  of  the  Bhadra-darvadi  and  the 
Pippalyddi  groups. 


Chap.  XVII.]  CHIKITSA  STHANAM.  419- 

Treatment  of    Pittaja    Visarpa  :— In 

cases  of  Pittaja  Visarpa^  a  plaster  consisting  of 
Kaseruka,  S'ringd-taka,  Padma,  Gundrd  ^Guduchi), 
S'aivdla,  Utpala  diX\d  clay  pasted  together  and  mixed, 
with  clarified  butter,  should  be  wrapped*  in  a  piece 
of  linen,  and  applied  cool  to  the  affected  part.  A 
paste  composed  of  Hrivera,  Ldmajjaka  (Us'ira-mula), 
Chandana^  Srotoja  (Rasanjana\  Muktd,  Mani  and 
Gairika,  pasted  together  with  milk  and  mixed  with 
clarified  butter  should  be  applied  thin  and  cool  to  the 
affected  part  to  alleviate  the  pain.  Pittaja  erysi- 
pelas readily  yields  to  the  application  of  a  medicinal 
plaster  composed  of  Prapaundarika,  Yashti-niAdhu, 
Payasyd,  f  Manjishthd,  Padmaka^  Chandana  and 
Sugandhikd  pasted  together.  Decoctions  of  the  drugs  of 
the  Nyagrodhddi  group  should  be  used  in  washing  (the 
affected  part)  ;  or  clarified  butter  should  be  cooked  with 
the  expressed  juice  of  the  above  drugs  and  employed 
in  the  case.  The  part  may  be  affused  (Seka)  with  cold 
milk  (or  water),  or  with  water  mixed  with  honey  or 
sugar,  or  with  the  expressed  juice  of  the  sugarcane.  4-5. 
Gauryadi  Ghrita:— A  Prastha  measure  of 
clarified  butter  should  be  cooked  with  the  Kalka  of 
Gauri,  \  Yashti-madhu,  Aravmda,  Rodhra,  Ambu, 
Rdjddanay  Gairika,  Rishahhaka^  Padmaka^  Sdrivdy 
KdkoH,  Medd,  Kumuda,  Utpala,  Chandana,  Madhu- 
S'arkard,  Drdkshd,  Stkird,  Prts'ni-parni,  and  S'atdhvd 
taken  in  equal  parts  (and  weighing    one   seer  §   in   all) 

*     In  order  to  facilitate    its  removal. 

t     It    means    "Kshira-vid^ri".     Jejjata   explains  it  as  "Arka-pushpi'*. 

X  Some  explain  it  as  "Haridra",  while  others  explain  it  as 
"Gorochand". 

§  Dallana,  however,  says  that  these  drugs  will  weigh  four  Pains 
i.  e.,  half  a  seer  in  all. 


'420  THE  SUSHRUtA  SAMHITA.  [Chap.  XVII. 

and  with  the  decoctions,  weighing  four  times  that  of  the 
Ghrita,  of  the  drugs  of  the  Nyagrodhddi,  Sthirddi  (minor 
Pancha-mula)  and  Vilvddi  (major  Pancha-mula) 
groups  together  with  the  same  weight  (sixteen  seers)  of 
milk.  The  washing  (of  the  affected  part)  with  this  me- 
dicated Ghrita  proves  curative  in  Pittaja  erysipelas  and 
sinus.  Visphota  (boils\  head  diseases,  malignant  sores 
and  inflammatory  affections  of  the  mouth,  yield  to 
the  internal  use  of  this  Ghrita.  It  is  called  the 
Giuryyaidi  Ghrita  and  is  highly  efficacious  in 
the  derangements  to  which  children  are  liable,  (com- 
monly) attributed  to  the  malignant  influences  of  evil 
stars,  as  well  as  in  cases  of  emaciated  ones.     6. 

Treatment  of    Kaphaja    Visarpa  :— 

Cases  of  the  Kaphaja  type  of  Visarpa  readily  yield  to  a 
proper  application  of  a  medicinal  plaster  (Pradeha) 
composed  of  Aja-gandkd,  As'va-gandhd,  Sarald^ 
Kdld,  Ekaishikd^  and  Aja-s'ringiX  pasted  with 
the  urine  of  a  cow.  Drugs,  such  as  Kdldnusdryd,  Aguru^ 
Chocha  (cardamom),  Gunjd,  Rdsnd,  Vachd^  S'ita-s'iva, 
Indra-parni^  Pdlindi,  Munjdta  and  Mahi-Kadamba 
^applied  similarly)  are  also  efficacious  in  the  present 
type.  Drugs  of  the  Varunddi  group  may  be  used  in  any 
form  (such  as  plasters,  washes,  etc*\  for  erysipelas. 
Blood-letting  (by  means  of  leeches)  and  Samsodhana 
(purifying)  measures  are  the  principal  remedies  in  all 
cases  of  this  disease  (Visarpa^.  Suppurated  erysipelas 
should  be  first  purified  and  then  treated  with  the  reme- 
dies described  in  the  treatment  of  Vrana  (ulcer),    7-8. 

*  «'SaraU"  here  means  '«Trivrit''.  Chakradatta  reads  *'^[TW" 
which  also  means   *'Trivrii", 

t  'Ekaishika,"  according  to  Uallana,  would  mean  S'atdvari  but 
S'ivadasa  explains  it  as  Pdlha. 

X  Gayadasa  explains  it  as  Karkata-S'ringi. 


Chap.  XVit]  CHIKITSA  STHANAM.  42 1 

Treatment  of  Nadi-vrana  :— A  Case  of 

Naidi-Vrana  (sinus)  due  to  the  concerted  action  of  the 
three  Doshas  (Sannipatajaj  baffles  all  cure,  while  the 
four  remaining  types  are  amenable  to  careful  medical 
treatment.  Poultices  (Upandhiy*  should  be  applied  at 
the  outset  in  the  Vaitaja  Nadi-Vrana  and  then 
the  course  of  the  pus-channels  should  be  (ascer- 
tained and)  fully  opened  (with  a  knife)  and  bandaged 
with  a  paste  of  sesamum,  Apd^ndr^-a-SQeds  and 
Saindhava  salt.  A  decoction  of  (the  drugs  of)  the 
Vrihat-Pancha-mula  group  should  be  constantly 
used  in  washing  the  ulcer.  Oil  f  duly  cooked  with 
the  following  drugs,  viz  ,  Hinisrd,  Haridrdy  Katuka^ 
Vald,  Gojihvikd  and  Viha-roots  should  be  used  for  the 
purification,  filling  up  and  healing  of  the  sores  of 
the  sinus.  9-1  r. 

Treatment  of  Pittaja  Nadi  :— In  a  case 

of  Pittaji  sinus,  an  intelligent  surgeon  should 
employ  a  porridge  (Utkarikaj  mixed  with  milk  and 
clarified  butter  as  a  poultice,  Then  having  opened 
the  sinus  with  a  knife,  a  plaster  composed  of  Tzla, 
Ndga-danti  and  Yashti-madhu  should  be  applied  to 
heal  it.  A  decoction  of  Soma,  Nimba  and  Haridrd 
should  be  used  by  a  skillful  surgeon  in  washing  the 
ulcer  daily.  A  medicated  Ghrita  cooked  with  S'ydmd^ 
Trivrit,  Triphald,  Haridrd^  Ddru-Haridrd^  Rodhra 
and  Kiitaja  and  with  milk  should  be  used  to  lubricate 
(Tarpana)  the  sinus.  This  Ghrita  will  even  heal  a  sinus 
affecting  the  Koshtha.    12-13. 

*  Poulticing  with  the  drugs  which  induce  suppuration  is  not  approv- 
ed of  by  Gayaddsa. 

t  Four  seers  of  oil,  the  (Kalka)  drugs  combindely  weighing  one 
seer  and  sixteen  seers  of  water  are  to  be  taken  in  its  preparation. — 
Dallana. 


422  tME  ^USHRUTA  SAMHITA.  [Chap.  XVIt 

Treatment  of  Kaphaja  Nstdi:— in  a  case 

of  the  Kaphaja  type  of  the  Nadi,  the  sinus  should  be  duly 
poulticed  i^Upanaha)  with  Kulattha,  white  mustard  seeds, 
S'aktu  and  Kinva.  When  softened  by  its  application, 
the  direction  of  the  sinus  (with  the  help  of  a  director) 
should  be  first  ascertained  ;  and  an  expert  surgeon  should 
then  open  it  fully  with  a  knife  and  plaster  it  with  a  com- 
pound composed  of  Nimba,  sesamum,  Saindhava  salt  and 
Saurdshtra-mrittikd.  A  decoction  (Sva-rasa-lit.— express- 
ed juice")  of  the  Karanja,  Nimba,  Jdti,  Aksha  and  Pilu 
should  be  used  in  washing  the  incidental  ulcer.  Oil  duly 
cooked  with  Suvarchikd,  Saindhava,  Chitraka,  Nikum- 
bha^  Tdli^  Nala,  Rupikd  and  Apdmdrg-a-scQds  and  with 
cow's  urine  should  be  used  for  healing  purposes.     14. 

Treatment  of  ^alyaja  Nadi  :— in  a  case 

of  Salyaja  Ns^di  (incidental  to  any  foreign  matter  into 
the  body),  the  Salya  should  be  first  extracted  by  an 
incision  into  the  sinus.  Then  having  fully  cleansed  the 
channel,  the  ulcer  should  be  purified  with  a  plaster  of 
sesamum  profusely  saturated  with  honey  and  clarified 
butter.  It  should  hz  then  healed  up.  Oil  cooked  with 
the  decoction  of  the  tender  fruits  of  the  Kumb/izka, 
K/iarj'ura,  Kapitthay  Vilva  and  the  Vanaspatis  (Vata, 
etc."*,  and  with  the  Kalkas  of  Mustd^  Sarald^  Priyangu. 
Sugandhikd,  Mocharasa,  f  Ahi-pushpa  (Ndgesvara), 
Rodhra  and  Dhdtaki  flowers  leads  to  a  speedy  healing 
up  (granulation)  of  ulcers  (Vrana)  and  traumatic 
sinuses.    15. 

*  Dallana's  reading  evidently  is  "Tali-lala"  and  he  explains  it  as 
the  roots  of  "Bhumyamalaki".  Chakradalta  also  prescribes  this  oil  but  he 
takes  "Nilika"  instead  of  "Tali".  S'ivadasa,  again,  in  his  commentary 
quotes  from  Sus'rula  but  reads  "Nili-Nala*  in  place  of  "Tala-Nala." 

t  "Mocha-rasa"  is  explained  by  Dallana  lo  be  "S'obhdnjana,"  but  it 
generally  means  '*S'almaIi-veshta/'and  S'ivadasa  ejcplains  it  as  such. — Ed. 


Chap.  XVII.]  CHIKITSA  STHANAM.  423 

Treatment  with  Kshara-Sutra :— An 

erudite  surgeon  should  open  a  sinus,  occurring  in  any 
of  the  Marmas,  or  in  a  weak,  timid,  or  emaciated  person 
with  an  alkalined  string  (KshaVa-Sutra\  and  not  with  a 
surgical  knife.  The  course  of  the  sinus  should  be  first 
ascertained  with  a  director  ;  and  a  needle,  threaded  with 
a  string  of  alkalined  thread  should  be  passed  from  one 
end  of  the  sinus  and  quickly  drawn  out  through  the  other. 
Then  the  two  ends  of  the  thread  should  be  firmly  fasten- 
ed together.  An  intelligent  surgeon  should  likewise  pass 
another  alkalined  thread  in  the  event  of  the  alkali  of  the 
first  thread  being  comparatively  weak.  This  should 
be  repeated  till  the  sinus  completely  bursts  out. 
The  surgeon  should  know  that  the  same  procedure 
may  be  as  well  adopted  in  cases  of  fistula-in-ano. 
Similarly  in  cases  of  tumours  (Arvuda),  etc.  they 
should  be  lifted  up  (with  the  hand)  and  tied  round  at 
their  base  with  an  alkalined  thread,  or  it  should  be 
punctured  around  with  a  kind  of  needle  with  their  mouth 
resembling  a  barley  corn  and  then  tied  again  at  their 
base  with  an  alkalined  thread.  After  their  bursting  (and 
falling  offj,  they  should  be  treated  as  common  ulcers 
(Vrana\     16. 

The  different  kinds  of  Plug-Stick  (Varti)  described 
in  the  Dvi-Vraniya  Chapter  (Chikitsita—chap.-i.)  may 
be  similarly  used  with  advantage  in  all  cases  of  sinus. 
The  use  of  a  plug  made  of  the  following  drugs,  viz., 
the  bark  and  fruit  of  the  Ghonta,  (the  five  officinal  kinds 
of)  salt,*  LdksM,  Puga  and  the  leaves  of  the  Alavand  \ 

*  According  to  Chakradatta's  reading  and  S'ivadas's  commentary  there- 
on, only  the  Saindhava  (instead  of  the  five  officinal  kinds  of  sail)  should  be 
taken.  We,  however,  follow  Dallana's  inttrpretation  with  good  results. -j^^. 

t  *'Alavana"  has  been  explained  by  Dallana  as  "Kaka-mardanika" 
and  by  S'ivadasa  as  "Jyotishmati".  S'ivadasa  is,  however,  followed  in 
practice  in  this  case, 


424  THE  SUSHRUTA   SAMHITA.  CChap.  XVII. 

pasted  together  with  the  milky  juice  of  the  Snuhi  and 
Arka  leads  to  the  speedy  healing  up  of  a  sinus.  The 
powdered*  stones  of  Vibhitaka^  mangoe  fruits,  Vata- 
sprouts,  Harenu,  S'amkhini-setd,  V drdhi-kanda  mixed 
with  oil  can  also  be  used  in  a  case  of  sinus.     17-19. 

The  seeds  of  the  Dhustura^  Madana  and  Kodrava, 
Kos'dtaki,  S'uka-nasd,  Mriga-bhojani  and  the  seeds  and 
flowers  of  the ^f//>^^/<3;  should  be  pounded  together  and 
applied  to  a  sinus  (Nddi)  after  having  washed  it  with  a 
decoction  of  Ldkshd.  Cases  of  sinus  speedily  yield 
to  the  curative  efficacy  of  the  application  of  these 
powders  mixed  with  oil.  The  use  of  the  oil  cooked 
with  cow's  urine  and  with  the  preceding  drugs  (as 
Kalkas)  brings  about  the  healing  up  of  a  sinus  in  seven 
nights.     20-21. 

The  application  of  the  oil  cooked  with  the  roots  of 
the  Pinditaka  treated  with  the  expressed  juice  of  the 
Vardha-kanda  in  the  manner  of  a  BhAvand  saturation 
and  with  the  bulbs  of  Suvahd  brings  about  a  speedy  and 
effective  remedy  for  a  sinus.  The  same  effect  is  pro- 
duced by  an  application  of  the  oil  cooked  with  the 
bulbs  of  the  the  Vajra-kanda.     22. 

Bhallatakadya    Taila:— The  use    of  the 

oil  cooked  with  the  paste  (Kalka)  of  Bhalldtaka, 
Arka,  Marichdi  Saindhava  salt,  Vidanga,  Haridrd, 
Ddru-Haridrd  and  Chitraka  and  with  the  expressed 
juice  of  the  Bhringa-rdja  readily  cures  cases  of  sinus, 
Apachi  and  ulcer  due  to  Vdyu  and  Kapha.     23. 

Treatment  of  Stana-roga :  -  In  cases  of 

a  derangement  of  the  milk  (of  the  breast)  a  draught  of 
clarified    butter   should    be  quickly  given    to  the  Dhatri 

*  According  to  some  different  reading  "burnt  ashes"  (instead  of  pow- 
ders) of  the  drugs  should  be  taken.  In  our  humble  opinion  the  reading  in 
the  text  seems  to  be  the  correct  one, 


Chap.  XVIL]  CHIKITSA  STHANaM.  425 

(mother  ov  wet-nurse)  by  the  physician  ;  and  in  the 
evening  a  draught  composed  of  the  decoction  of  Nimba, 
mixed  with  honey  and  Mdgadhikd,  should  be  given 
to  her  for  emetic  purposes.  Next  day  she  should 
take  a  meal  (of  boiled  rice)  with  the  soup  (Yusha) 
of  Mudga  pulse.  The  use  of  emetics  should  be 
continued  for  three,  four,  or  six  days  ;  or  she 
should  be  made  to  drink  a  potion  of  clarified  butter 
(cooked)  with  Triphald,  A  decoction  of  Bhdrgi, 
Ativishd,  Vachd,  Sura-ddru,  Pdthd,  the  drugs  of  the 
Mustddi  Gana,  Murvd  and  Katu-rohini,  or  that  of  the 
drugs  of  the  Ai^agvadhddi  group  mixed  with  honey, 
should  be  given  to  the  Dhdtri  ^wet-nurse)  for  the  purifi- 
cation of  her  breast-milk.     26. 

The  above  are  the  general  remedial  measures  which 
are  to  be  adopted  in  the  affections  of  breast-milk.  Any 
other  defect  in  the  breast-milk  should  be  corrected 
specially  with  an  eye  to  the  nature  of  the  Dosha 
involved  in  the  case.  In  cases  of  inflammatory 
swellings  of  the  breasts,  the  physician  should  remedy 
them  by  means  of  any  one  of  the  various  measures  laid 
down  under  the  head  of  Vidradhi  with  a  due  considera- 
tion to  the  requirements  of  each  particular  case.  Medici- 
nal remedies  should  only  be  internally  employed  and  no 
poultices  should  be  applied  for  the  speedy  suppuration 
of  the  swelling  of  the  breast,  even  if  found  to  have  al- 
ready commenced  to  suppurate  ;  since  the  breasts  are  of 
an  extremely  soft  and  fleshy  growth,  any  tight  banda- 
ging about  those  parts  may  be  followed  by  local  slough- 
ing or  even  bursting.  In  a  case  where  suppuration  had 
already  taken  place,  an  operation  should  be  made 
in  the  affected  part,  avoiding  the  milk-carrying  veins 
as  well  as  the  nipple  with  its  black  surroundings. 
In      all      the       cases      of      Stana-V  id  rad  hi— whether 

54 


426  THE  SUSHRUTA  SAMHITA.  [Chap.  XVlt. 

non-suppurated,    suppurating^,     or     suppurated— the 

milk    should    be    pressed   out   from   the   breast   of  the 
Dhatri*     27-29. 

Thus  ends  the  Seventeenth  Chapter  of  the  Chikitsita  Sthanam  in  the 
Sus'ruta  Samhita  which  deals  with  the  treatment  of  erysipelas,  sinus 
and  the  diseases  of  the  mammary  glands. 


*  The  milk  should  be  pressed  out  of  the  Dhatri's  breasts  in  the 
non-suppurated  stage,  to  alleviate  the  burning  sensation  therein,  in  the 
suppurating  stage  for  the  avoidance  of  further  suppuration,  and  in  the 
suppurated  stage  for  the  prevention  of  sores,  sinus,  etc. 


CHAPTER  XVIII. 

Now  we  shall  discourse  on  the  medical  treatment 
of  Glandular  Swellings,  etc.  (Gratlthl),  Scurvy 
(Apachi),  Tumour,    etc.       (Arvuda)    and    Goitre 

(Gala-g^anda).    i 

General  treatment   of    Granthi  :— In 

the  non-suppurated  or  acute  (inflammatory)  stage  of 
Granthi,  an  experienced  physician  should  prescribe 
the  measures  #  laid  down  in  connection  with  (in- 
flammatory) swellings  (Sopha)  in  general.  As  bodily 
strength  arrests  the  progress  of  the  disease,  the 
strength  of  the  patient  should  hence  be  always  carefully 
guarded  against  suffering  any  diminution  in  that  respect. 
The  patient  should  be  made  to  drink  oil,  or  clarified 
butter,  or  both  ;  or  he  should  be  made  to  drink  lard, 
oil  and  clarified  butter,  mixed  together.f  Apehivdtd 
(Prasarani)  and  Das'a-mula  cooked  with  the  four  kinds 
of    lardacious     or   emollient   substances    (oil,    clarified 

*    Beginning  with  Apatarpana  up  to  the  purgative  measures. 

t  Oil,  clarified  butter  and  lard  mixed  together  is  technically  called 
the  "Trivrita."— Dallana. 

In  the  case  of  a  Vataja  Granthi,  a  potion  of  oil  cooked  with  the 
decoction  and  paste  (Kalka)  of  the  Vayu-subduing  drugs  should  be 
prescribed  for  the  patient  ;  in  the  case  of  a  Pittaja  Granthi,  clarified 
butter  cooked  with  the  decoction  and  Kalka  of  the  Pitta-subduing  drugs 
should  be  administered  in  the  same  manner  ;  while  in  the  case  of  a  Kaphaja 
Granthi,  oil  cooked  with  the  decoction  and  Kalki  of  the  Kapha-subduing 
drugs  should  be  taken  by  the  patient.  But  in  a  case  of  Granthi  due  to 
the  concerted  action  of  the  two,  or  three  of  the  Doshas,  any  compound 
medicated  oil,  prepared  by  cooking  any  two,  three,  or  four  of  the  oily 
substances,  viz.^  oil,  clarified  butter,  lard  and  marrow,  with  the 
decoction  and  Kalka  of  those  drugs  which  are  antidotes  to  the  said 
Doshas,  should  be  prescribed  for  the  patient  as  drinks, 


428  THE  SUSHRUTA  SAMHITA.        [Chap.  XVIII. 

butter,   lard   and    marrow),   or   with   any   two  of  them 
should  be  prescribed.     2-3. 

Treatment    of    Vsitaja    Cranthi  :~A 

medicinal  plaster  composed  of  Himsrd,  Rohiniy  Amritd, 
Bhdrgi^    S'yondka,  Viha,  Aguru,  Krishna-gandhd,    Goji 
and     Tdla-patri    (Tdla-parni — D.   R )  pasted    together, 
should     be   applied     ito    the    inflamed    gland)   in    the 
Vaitaja    type     of  Granthi.     Different  kinds  of  fomen- 
tation   (Sveda),   poulticing     (Upanahaj   and    medicinal 
plasters   (Lepa),   possessed    of    the   efficacy   of    subdu- 
ing the  deranged  Vdyu,  should  be  likewise  resorted  to.  A 
suppurated  swelling  should  be  opened  and  the  pus  drained. 
Then     the     incised   wound   should    be   washed  with  a 
decoction  of    Vilva^   Arka    and  Narendra  (Aragvadha) 
and    purified    (disinfected)    with   a    plaster  consisting  of 
sesamum  and  the  leaves  of  the  Panchndgula    (castor  oil 
plants),     together     with     Saindhava    salt.       After   the 
purification,     it   should    be    healed    up    by    applying    a 
medicated  oil,  mixed  with   the    powders  of  Rdsnd   and 
Sarald  ;  or  by  a  medicated  oil  prepared    by    cooking   it 
with    Vidanga,    Yashti-madhu    and    Amritd   and    cow's 
milk.    4. 

Treatment  of  Pittaja  Granthi:— In  a 

case  of  the  Pittaja  type  of  the  disease,  leeches  should 
be  applied  to  the  affected  part,  which  should  be  further 
affused  with  milk  and  water.  The  patient  should  be 
niade  to  drink  a  cold  decoction  of  the  drugs  of  the 
Kdkolyddi  group  with  the  addition  of  sugar ;  or  he 
should  take  the  powders  of  Haritaki  through  the 
medium  of  grape-juice,  or  of  the  expressed  juice  of  sugar- 
cane. Hot  plasters,  prepared  by  pasting  together  the 
bark  of  the  Madhuka  (flower)   tree,    and    of  the  Jambu 

*     Some   read    *'1%'^T^^^Tl%^ia:"  and  explain  that  the\decocUons  of 
the  Vilvadi  and  the  Arkadi  groups  are  to  be  taken  for  the  purpose. 


Chap.  XVIII.  ]  CHIKITSA  STHANAM.  429 

tree,  Arjuna  tree,  and  Vetasa  creeper.  As  an  alter- 
native, hot  plasters  compounded  of  the  roots  of  the 
Trina-s'unya  (Ketaki),  or  Muchukunda  mixed  with 
sugar,  should  be  constantly  applied  to  the  affected  part. 
The  Granthi  should  be  opened  when  fully  suppurated, 
and  the  pus  let  out  ;  after  which  it  should  be  washed 
with  a  decoction  of  the  bark  of  the  Vanaspati^  The 
incidental  ulcer  should  then  be  purified  with  a  plaster 
composed  of  sesamum  and  Yashtimadhu  ;  and  lastly  it 
should  be  healed  up  with  clarified  butter  cooked  with 
the  drugs  of  the  Madhii7'a  (Kdkolyadi   group.      5-6. 

Treatment  of  Kaphaja  Granthi :— In  a 

case  of  the  Khaphaja  type  of  the  disease,  the  Doshas 
should  be  first  eliminated  from  the  system  with  the 
regular  and  successive  measures. f  The  affected  part 
(Granthi)  should  then  be  fomented  and  firmly  pressed 
(Vimlapana)  and  rubbed  with  either  the  thumb,  or  a 
piece  of  iron  rod,  or  stone,  or  with  a  bamboo  rod  in  order 
to  bring  about  its  resolution.  A  plaster  composed  of  the 
roots  of  the  Vikamkata,  J  Aragvadha,  Kdkananti  (Gunja), 
Kdkddani  (Vayasa-tinduka),  and  Tdpasa-Vriksha 
(Ingudi)  and  with  Pinda-phala  (Tiktdldvu),  Arka,  § 
Bhdrgi,  Karanja,  Kdld  and  Madana^  pasted  together, 
should  be  applied  to  it  by  an  erudite  physician.  A 
glandular  swelling  v Kaphaja  Granthi)  on  any  part  of  the 
body  other  than  a  vital  and  vulnerable  one  (Marma)  and 

*  The  Vanaspati  class  consists  of  Vata,  Plaksha,  As'vatlha  and 
Udumbara  frees. 

t  These  are  ihe  applications  of  Sn^ha,  fomentation,  emetics,  pur- 
gatives, Asihapana,  S'iro-virechana  and  blood- letting. 

X  Dallana  explains  "Vikamkata"  as  "Kanta-karika,"  but  it  means 
Sruva  (called  Vainch  in  Bengal)  and  S'ivadasa  also  explains  it  as 
such,— i^r/. 

^     Chakradatia  does  not  read  "Arka"  in  the  list. 


430  THE  SUSHRUTA  SAMHITA.        [Chap.  XVIII. 

not  (otherwise)  resolved  and  absorbed  should  be  cut  open 
even  in  its  non-suppurated  stage  and  the  glands 
removed.  The  expert  surgeon  should  then  cauterize  the 
incidental  wound  after  the  cessation  of  the  bleeding  and 
treat  it  in  the  manner  *  of  the  Sadyo-Vrana  treatment. 
These  remedies  should  be  employed  by  the  experienced 
physician,  where  the  swelling  would  be  found  to  have 
assumed  a  large,  stiff,  elevated  and  fleshy  aspect 
(bulging  from  the  deeper  tissues  of  the  flesh).  A 
Kaphaja  Granthi  should  be  opened  with  an  incision  as 
soon  as  it  becomes  fully  suppurated  and  should  then  be 
washed  with  a  decoction  of  appropriate  medicinal 
drugs.  The  incidental  ulcer  should  be  purified  (disin- 
fected) with  a  purifying  remedy  prepared  with  a 
profuse  quantity  of  Yava-kskara,  honey  and  clarified 
butter ;  and  finally  it  should  be  healed  up  by  the 
application  of  an  oil,  cooked  with  Vidanga,  Pdthd  and 
RoJiini.     7-9. 

Treatment  Of  Medoja  Granthi  : -In  a 

case  of  Medoja  Granthi  (originated  from  the  vitiated 
condition  of  the  bodily  fat)  a  plaster  of  pasted  sesamum, 
placed  inside  the  folds  of  a  piece  of  linen,  should 
be  applied  to  the  seat  of  the  affected  part  and  fomen- 
tations with  hot  iron- rods  should  be  frequently  applied, 
inasmuch  as  application  of  heat  (lit. — fire)  is  efficacious 
in  such  cases.  As  an  alternative,  the  affected  part 
should  be  fomented  with  a  ladle,  pasted  with  heated 
shellac  (Ldksha).  The  Granthi  (in  its  non-suppurated 
stage)  should  be  opened  by  an  incision  and  the 
fat  removed  ;  the  incidental  ulcer  should  then  be 
(actually)  cauterized.  On  the  other  hand,  the  Granthi, 
when  fully  suppurated,  should  be  incised  and  washed 
with  the  urine  (of  a  cow).  Then  a  paste,  composed  of 
*     Applications  of  honey,  clarified  butter,  etc. 


Chap.  XVIlI.]  CHIKITSA  STHANAM.  431 

sesamum,  Suvarchikd,  Haritdla  and  rock-salt,  pounded 
together  and  mixed  with  honey,  clarified  butter  and  an 
abundant  quantity  of  Yava-kshara,  should  be  applied 
to  the  incidental  wound  for  purifying  purposes.  Oil, 
cooked  with  the  two  kinds  of  Karanja,  Gunjd^  the 
green  scrapings  of  bamboo,  Ingudi  and  the  urine  *  of  a 
cow,  should  be  used  to  heal  the  ulcer.     lo-ii. 

Treatment  of  Apachi  :— Clarified  butter 
cooked  with  the  fruit  of  Jimictaka  and  Kosha-vati, 
and  with  (the  roots  of)  Danii,  Dravanti  and  Trivrit^ 
is  a  very  powerful  and  efficacious  remedy.-|*  Adminis- 
tered internally  as  well  as  externally,  it  leads  to  the 
cure  of  the  advanced  cases  of  Apachi.     12. 

A  strong  emetic  composed  of  Nirgundi,  Jdti  (flower) 
.and  Varihistha  (Vala)  together  "^ith.  Jitmitaka,  profusely 
mixed  with  honey  and  Saindhava,  should  be  given 
warm  to  the  patient.  It  is  a  very  powerful  emetic, 
and  leads  to  the  recovery  of  even  a  malignant  form 
of  Apachi.  An  oil,  cooked  with  the  pastes  (Kalka)  of 
K